The association of non-HDL-cholesterol and non-HDL-C-to-HDL-cholesterol ratio (non-HDL-C-to-HDL-C ratio) with early diabetic nephropathy in patients with type 2 diabetes mellitus was investigated.Non-HDL-C and non-HDL-C-to-HDL-C ratio were positively related with microalbuminuria (P＜0.05 or P＜0.01).Non-HDL-C-to-HDL-C ratio is an independent risk factor of early diabetic nephropathy in patients with type 2 diabetes mellitus.

OBJECTIVEIt has been proposed that aberrant immunity of local bowel mucosa may cause ulcerative colitis (UC) and the tumor necrosis factor-alpha (TNF-alpha) and nuclear factor-kappa B (NF-kappa B) may play a role in the development of this disease. To investigate the role of TNF-alpha and NF-kappa B in childhood UC, the expression of TNF-alpha and NF-kappa B in the bowel mucosa and their relationship were studied.

METHODSUsing anti-CD68, anti-TNF-alpha and anti-NF-kappa Bp65 antibodies, the cytokine immunoreactivities in the bowel mucosa of 39 cases of childhood UC (active UC: n = 21, non-active UC: n = 18) were detected by immunohistochemistry. The control specimens of normal bowel mucosa were collected from 7 cases with colorectal polyp or abdominal pain by sigmoidoscopy.

RESULTSThe numbers (median: interquartile range) of CD68(+) cells, TNF-alpha(+) cells and NF-kappa Bp65(+) cells were 44.0 (31.5 - 48.2), 42.7 (19.5 - 65.0) and 50.7 (30.0 - 58.0) in the active UC mucosa, and were 9.2 (7.9 - 16.6), 5.5 (2.5 - 9.1) and 4.2 (3.0 - 8.4) in non-active UC mucosa, and 5.3 (4.3 - 8.7), 3.0 (0.0 - 6.3) and 3.3 (0.0 - 4.0) in the control mucosa, respectively. The levels of CD68, TNF-alpha and NF-kappa Bp65 expressions in the active UC were significantly higher than those in the non-active UC (P < 0.001) and the controls (P < 0.001). The expression level of CD68 in non-active UC was much higher than that in the controls (P = 0.008). Using the correlation analysis, a positive correlation between TNF-alpha and NF-kappa B activation was found (r = 0.885, P < 0.001).

CONCLUSIONSMacrophages TNF-alpha and NF-kappa B may play an important role in the pathophysiologic mechanism of childhood active UC. The activation of NF-kappa B may be associated with the release of TNF-alpha.

Adolescent ; Antigens, CD ; analysis ; Antigens, Differentiation, Myelomonocytic ; analysis ; Child ; Child, Preschool ; Colitis, Ulcerative ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Infant ; Male ; NF-kappa B ; analysis ; Tumor Necrosis Factor-alpha ; analysis

OBJECTIVEDuodenal salami ulcer is a common disease found on routine endoscopic examination in children. The purpose of the study was to explore the characteristics and the clinicopathological features of duodenal salami ulcer in children and to deepen the understanding of duodenal salami ulcer.

METHODSThe endoscopic results of 117 cases with the duodenal salami ulcer were analyzed. The specimens of gastric antrum and duodenal bulb were subjected to HE and Giemsa staining and were examined for any alteration in histopathology and infection with Helicobacter pylori (Hp). The duodenal mucosa was stained with AB (pH 2.5)/PAS in order to diagnose the duodenal metaplasia.

RESULTSThe major endoscopic finding was a kind of hoarfrost, which was dotty or flaky, covered on the hyperemic and edematous mucosa. The detection rate of this change was 2.29% (117/5 106) of all the endoscopic examinations in children and the rate among cases with duodenal ulcer was 49.2% (117/238). The histopathology was characterized by a heavy infiltration of mainly lymphocytes, plasmocytes and neutrophilic granulocytes, frequently accompanied by superficial erosion. Sixty-one cases were pathologically diagnosed as chronic active duodenitis, superficial erosion in 45; chronic duodenitis in 50; eosinophilic duodenitis in 6. Detection rate of Hp in gastric antrum was 58% (68/117) of all cases. Detection rate of Hp infection and gastric epithelium metaplasia in duodenal bulb was 11.1% (13/117) and 31.1% (37/117), respectively. However, detection rate of Hp in gastric antrum was 25.0% (1 203/4 810) in 4 810 cases of normal duodenal bulb and chronic duodenitis in the same period. Detection rate of Hp in duodenal bulb was 0% and the detection rate of gastric epithelium metaplasia in duodenal bulb was 2.7% (128/4 810). All these detection rates were much higher than those of the specimens collected during the same period with normal duodenal bulb and chronic duodenitis (P < 0.001). Twenty-one cases were reexamined by endoscopy after having been treated with antacids or antacids and antimicrobial agents for 4 weeks. The lesions were healed up and no scars were found.

CONCLUSIONDuodenal salami ulcer in children had a special manifestation of duodenal inflammation or erosion but not a real ulcer. It was caused by the Hp infection in gastric antrum or duodenal bulb and the increase of gastric acids. The therapeutic principles were antacid and antimicrobial agents. The prognosis was good.

Adolescent ; Child ; Duodenal Ulcer ; complications ; pathology ; Duodenum ; pathology ; Female ; Helicobacter Infections ; complications ; Humans ; Male ; Pyloric Antrum ; pathology

Disease Management ; Humans ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; drug therapy ; surgery

OBJECTIVETo study molecular epidemiology of norovirus (NV) infections, stool specimens collected from children with acute diarrhea were tested by TaqMan real-time reverse transcription polymerase chain reaction (RT-PCR) for the viral specific nucleic acid segments.

METHODSFecal samples from a total of 1260 children who had watery diarrhea seen from December 2006 to December 2007 in Guangzhou were analyzed by real-time RT-PCR. The primers and probes used for rapid detection and typing of NV strain target NV sequences were at the ORF1-ORF2 junction, a highly conserved region of the NoV genome. The positive specimens were determined by nested PCR and sequenced.

RESULTSTotally 257 specimens were positive for NV with a positive rate of 20.40%. Shedding of NV type GI was detected in 6.90%, type GII in 16.98% respectively, while the positive number of mixed infection with GI and GII was 44. Of the NV strains that were cloned and sequenced, GI was GI-3, GI-2 and GI-4 detected in positive specimens respectively; meanwhile, GII-4 was most commonly seen in genome II, followed by GII-3 and GII-7. In addition, the average age of children infected with NV was less than 2 years. An epidemic occurred during the winter and early spring (December through the next March).

CONCLUSIONNV was one of the important pathogens for acute diarrhea among children in Guangzhou, which suggested GII-4 was the prevalent strain.

Caliciviridae Infections ; epidemiology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; etiology ; virology ; Feces ; virology ; Humans ; Infant ; Molecular Epidemiology ; Norovirus ; classification ; genetics ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVEHelicobacter pylori (Hp) infection presents high prevalence in the world, but there are few pediatric assays evaluating antimicrobial treatment using a short regimen of triple therapy. To evaluate the eradication rate and long term therapeutic effect of a triple therapy consisted of omeperazole, clarithromycin (CLA) and amoxycillin (AMO) on Hp infection, the authors explored the alternative therapeutic programs and their effects after first therapeutic failure.

METHODSA total of 192 children with Hp infection were divided into two groups: 157 children were given the triple therapy for one week (CLA group); 35 children were given another triple therapy composed of omeperazole, metronidazole (MET) and AMO for two weeks (MET group). All of the children were followed up for 1 - 36 months after the therapies ended. Twenty-two children in whom Hp was eradicated with CLA triple therapy were followed up for 3 years. The children of the two groups who had therapeutic failure were given re-treatment as follows. CLA triple therapy was given for one week to the children who had failure after MET triple therapy; increased doses of CLA with longer treatment course was given to the children who had failure after CLA triple therapy. A tetra therapy consisted of omeperazole, colloidal bismuth subcitrate (CBS), furazolidone (FUR) and AMO was given to the children in whom the re-treatment failed.

RESULTSThe Hp eradication and ulcer recovery rate of CLA group was 90.4% (142/157) and 96.9% (32/33), respectively; the Hp eradication rate of MET group was 77% (27/35). There was significant difference between eradication rates of the two groups (chi(2) = 4.69, P < 0.05). The recurrence rate of 22 Hp eradicated children treated with CLA triple therapy was 4.5% (1/22) during the 3-year follow-up. The eradication rate of the three re-treatment programs for 29 children was 75% (6/8), 77% (11/15) and 100% (6/6), respectively.

CONCLUSION(1) Omeperazole, CLA and AMO triple therapy for one week was the best to eradicate Hp infection with high eradication rate, few side effects, short period of treatment, good compliance and low recurrence rate. (2) Proper increase of CLA dose and longer therapeutic course may increase the eradication rate. Omeperazole, CBA, FUR and AMO tetra therapeutic program may be used as an alternative treatment in patients who develop resistance to CLA triple therapy.

Adolescent ; Amoxicillin ; administration & dosage ; therapeutic use ; Anti-Ulcer Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; administration & dosage ; therapeutic use ; Female ; Follow-Up Studies ; Helicobacter Infections ; drug therapy ; Helicobacter pylori ; drug effects ; Humans ; Male ; Metronidazole ; administration & dosage ; therapeutic use ; Omeprazole ; administration & dosage ; therapeutic use ; Recurrence ; Time Factors ; Treatment Outcome

OBJECTIVETo study clinical features, treatment and curative effects in children with acute clenbuterol poisoning, in order to provide a basis for early diagnosis and treatment.

METHODSClinical data of 28 hospitalized children with acute clenbuterol poisoning in April 2011 were retrospectively studied.

RESULTSOf the 28 patients, there were 15 males and 13 females, aged 1 to 13 years (mean age 6.5±4.8 years). Vomiting, palpitations and limb shaking were found as main clinical manifestations in the patients. Main changes of blood biochemical included hypokalemia, lactic acidosis, hyperglycemia, hypsocreatinkinase. Snus tachycardia and S-T segment depression were observed on ECG. Patients' symptoms were gradually alleviated after 12-78 hours by use of beta blockers, potassium supplement, protecting the heart and other symptomatic and supportive treatment. Blood biochemical indexes were improved after 48 hours of admission. All of the patients were cured after 5 days. The symptoms of the patients do not longer occur during a follow up of half a month.

CONCLUSIONSAcute clenbuterol poisoning is characterized by vomiting, palpitations, limb shaking, hypokalemia, lactic acidosis and tachycardia in children. An early effective treatment of this disease can improve prognosis in children.

Acute Disease ; Adolescent ; Adrenergic beta-Agonists ; poisoning ; Child ; Child, Preschool ; Clenbuterol ; poisoning ; Electrocardiography ; Female ; Humans ; Infant ; Male ; Retrospective Studies

BACKGROUNDThe relationship between the 6-minute walk test (6MWT) and pulmonary function test in stable chronic obstructive pulmonary disease (COPD) remains unclear. We evaluate the correlation of 6MWT and spirometric parameters in stable COPD with different severities. 6MWT data assessed included three variables: the 6-minute walk distance (6MWD), 6-minute walk work (6MWORK), and pulse oxygen desaturation rate (SPO(2)%).

METHODS6MWT and pulmonary function test were assessed for 150 stable COPD patients with different severities. Means and standard deviations were calculated for the variables of interest. Analysis of variance was performed to compare means. Correlation coefficients were calculated for 6MWT data with the spirometric parameters and dyspnea Borg scale. Multiple stepwise regression analysis was used to screen pulmonary function-related predictors of 6MWT data.

RESULTSThe three variables of 6MWT all varied as the severities of the disease. The 6MWD and 6MWORK both correlated with some spirometric parameters (positive or negative correlation; the absolute value of r ranging from 0.34 to 0.67; P < 0.05) in severe and very severe patients, and the SPO2% correlated with the dyspnea Borg scale in four severities (r = -0.33, -0.34, -0.39, -0.53 respectively; P < 0.05). The 6MWD was correlated with the 6MWORK in four severities (r = 0.56, 0.57, 0.72, 0.81 respectively, P < 0.05), and neither of them correlated with the SPO(2)%. The percent of predicted forced expiratory volume in 1 second (FEV(1)% predicted) and residual volume to total lung capacity ratio (RV/TLC) were predictors of the 6MWD, and the maximum voluntary ventilation (MVV) was the predictor of the 6MWORK.

CONCLUSIONS6MWT correlated with the spirometric parameters in severe and very severe COPD patients. 6MWT may be used to monitor changes of pulmonary function in these patients.

Aged ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Oxygen ; blood ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; Regression Analysis ; Respiratory Function Tests ; Walking ; physiology

Objective To explore the monitoring of cerebrospinal fluid (CSF) dynamics in a model of brain herniation induced by acute intracranial hypertension in Guangxi Bama-Mini pigs by phasecontrast cine magnetic resonance imaging (PC cine MRI).Methods Femoral artery blood were extracted from 10 pigs,and injected into the frontal and temporal parietal lobe to make a model of brain herniation induced by acute intracranial hypertension.The mean arterial blood pressure (MAP),intracranial pressure (ICP),and cerebral perfusion pressure (CPP) were monitored.Routine T1WI,T2WI,coronal,sagittal and cerebrospinal fluid flow sequence (fast PC cine slice) which positioned on the cervical 3 (C3) vertebral body as the center and perpendicular to the spinal scans were performed on all experimental animals before and after blood injection with 3.0T Magnetic Resonance Imaging.The ICP,MAP,CPP,the absolute values of CSF peak flow velocity and the absolute value of carotid peak flow velocity before and after blood injection were compared.Results The ICP,MAP,CPP,and the absolute value of CSF peak flow velocity before injection of autologous arterial blood were statistically significant as compared with those after blood injection [(6.80±2.044) mmHg vs (52.20±1.619) mmHg,(76.80±7.068) mmHg vs (142.80±12.399) mmHg,(70.00±6.074) mmHg vs (90.50±12.250) mmHg,and the absolute value of CSF peak flow velocity was (243.20±77.671) mm/s vs (201.40±55.482) mm/s,respectively,P＜0.01].The absolute value of the peak velocity of the carotid artery before blood injection was not statistically significant compared with that after blood injection [(876.80±239.908) mm/s vs (799.40±241.829) mm/s,P＞0.05].Conclusion After the formation of brain herniation induced by acute intracranial hypertension,the CSF flow in the C3 level spinal canal showed a low dynamic change,and the CSF flow velocity waveform was disordered and malformed.The non-invasive measurement of CSF dynamics by PC cine MRI can provide an important basis for the change of CSF dynamics in the model of brain herniation induced by acute intracranial hypertension,and provide a theoretical basis for further research on damage control neurosurgery in the future.

Objective Investigate the effect of gestational diabetes mellitus (GDM)on the neonatal metabolism and prognosis.Methods A total of 265 singleton pregnancy GDM patients were collected as the observation group,while 260 cases of healthy singleton pregnant women were chosen as the control group.Detected the levels of adiponectin,insulin,C-peptide,glycated hemoglobin and blood glucose,compared the prognosis of two groups.Results Compared with the control group,adiponcetin and blood glucose in 2 hours after birth in observation group were lower,insulin,C-peptide and glycated hemoglobin were higher,the number of cesarean section was more,the difference was statically significant (P＜0.05).The incidence of low birth weight infant,macrosomia,neonatal asphyxia,neonatal hypoglycemia,neonatal hyperbilirubinemia,neonatal pneumonia,fetal death and newborn teratogenesis in the observation group was higher than that in the control group,the difference was statically significant (P＜0.05).Conclusion GDM could cause metabolic disorder and affect fetal growth and development,leading to poor prognosis.