Child ; Colitis ; diagnosis ; Colon, Sigmoid ; pathology ; Diagnosis, Differential ; Diarrhea ; etiology ; Eosinophilia ; complications ; diagnosis ; Female ; Gastroenteritis ; complications ; diagnosis ; pathology ; Humans ; Sigmoid Diseases ; complications ; diagnosis ; pathology ; Sigmoidoscopy

OBJECTIVETo analyze possible risk factors for diarrhea in breast fed infants and provide evidences for prevention and treatment of diarrhea, reducing allergic and other diseases in infants and for renewing the definition of "physiological diarrhea".

METHODSTotally 334 infants (207 boys and 127 girls, mean age 3.0 +/- 0.4 months) who were solely breast fed and seen between August 2004 and June 2006 at the outpatient clinic of the Department of Pediatrics, the 3rd Hospital of Peking University were enrolled in this study. The following information concerning parental and the infants' possible risk factors was obtained through a questionnaire that included parents' age, education, smoking, alcohol consumption, weight, height, maternal pregnancy weight, weight gain and health status during pregnancy and family history of hypersensitivity, family history of digestive tract disease, diet of mother in lactation, the infants' age, height, weight, head circumference, chest circumference, rash, eczema, diet, vomiting, abdominal distention, and blubber. The levels of PGE(2), fat and lactose in breast milk, serum allergen and skin prick test were performed in all the 334 infants. Logistic regression analysis was performed by using the software SPSS 10.0.

RESULTSMaternal smoking (OR = 2.3), hypersensitivity (OR = 2.7), family history of hypersensitivity (OR = 2.8), diet of mother included seafood (OR = 1.8), egg (OR = 2.3) and peanut (OR = 2.0), infants' eczema (OR = 2.9), blubber (OR = 2.7), high level of PGE(2) (OR = 2.4) and fat in breast milk (OR = 3.0), serum allergen positive (OR = 4.0), positive skin prick test (OR = 2.7) were the risk factors for diarrhea in breast fed infants (P < 0.05).

CONCLUSIONSDiarrhea in breast fed infants is not a simple physiologic process. It may be associated with many factors and the underlying mechanism remains to be clarified via further studies.

Breast Feeding ; adverse effects ; Dermatitis, Atopic ; complications ; Diarrhea, Infantile ; etiology ; Diet ; Female ; Humans ; Hypersensitivity ; complications ; Infant ; Logistic Models ; Male ; Maternal Behavior ; Milk, Human ; chemistry ; Risk Factors ; Smoking

Transverse fracture is the most common in patella fracture and tension band fixation is one of the most effective methods. Surgical wire tension band technique is simple, the use of materials is also simple, but it is not strong and difficult to promote. Kirschner tension band technique can get satisfactory reduction with reliable fixation, but it is easy to complicate with steel wire breakage and Kirschner loosening. Screw tension band technique inherits the traditional advantages of simple manipulation and reliable fixation, also overcomes the disadvantages of early activity limitations caused soft tissue irritation of tension band around knee, the slippage and breakage of internal fixation, and the technique can be popularized generally.
Bone Wires ; Fracture Fixation, Internal ; methods ; Humans ; Patella ; injuries ; surgery ; Stress, Mechanical

Objective To analyze the clinical characteristics of infants with functional constipation(FC)relating to food allergy(FA)and explore its ways of diagnosis and therapy.Methods The detail clinical information of the patients who corresponded to the criteria of diagnosis of FC and FA simultaneous from Mar.2007 to Dec.2009 were reviewed and analyzed.There were 496 cases of FA,in the FA joint clinic,gastroenterology clinic and pediatric ward,56 cases of them had the symptoms of FC(56/496 cases,11%),diets free and amino acid-based formulae were the treatments of the patients.The 56 cases were analyzed with skin-prick test(SPT),serum special IgE and serum special IgG,and the risk factors attributed to the no response to treatments with Logistic regression.Results Fifty-six cases opened the bowel less than twice a week,and companied with pain,8 patients with soiling once a week at least,10 patients with fecal retention,4 patients with large fecal in rectum.Mother or father with the history of allergy were 22 cases,17 cases,separately,both of mother and father with the history of allergy were 17 cases.The results of SPT,serum special IgE and serum special IgG showed that the patients with different allergens,cow's milk,egg,cod,especially.The patients with FC relating to FA were breast-feed,battle-feed or mix-feed.Treatment relied on amino acid-based formulae,as well as elimination diets in infants,80%of them(45/56 cases)improved.Introducing solid foods,the age of upsetting constipation and premature were the risk factors contributed to the no response to the diet free treatment.Conclusion FA should be consi-dered to contribute to the infants presenting with FC.Diets free and amino acid-based formulae may be effective.

OBJECTIVETo observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.

METHODSFifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.

RESULTSCompared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).

CONCLUSIONThe Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.

Acupuncture Therapy ; Aged ; Female ; Hand ; physiopathology ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Movement ; Recovery of Function ; Stroke ; complications ; physiopathology

OBJECTIVETo investigate the complications of twin-twin transfusion syndrome (TTTS) in preterm infants and to analyze the clinical conditions and prognosis of cardiac abnormalities in TTTS recipients.

METHODSA retrospective analysis was performed on the clinical data of 17 pairs of preterm infants with TTTS born between June 2009 and December 2012.

RESULTSCompared with the recipients, the donors had significantly lower body weights (1.4±0.6 kg vs 1.9±0.6 kg; P<0.05). With treatment during pregnancy, cardiac complications were found in 14 cases, and brain injuries in 12 cases. The proportion of recipients with cardiac abnormalities (60%) was higher than that of donors (24%). Among 10 recipients who had cardiac complications, cardiac abnormalities mainly included valve thickening, stenosis, or atresia (50%).

CONCLUSIONSAmong preterm infants with TTTS, the recipients are more susceptible to complications of valvular heart disease and cardiomyopathy. Fetal echocardiography, evaluation of cardiac function, and treatment should be performed for recipients as early as possible to improve the prognosis.

Female ; Fetofetal Transfusion ; complications ; Heart Defects, Congenital ; etiology ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Pregnancy ; Retrospective Studies

Food allergy is defined as abnormal immune response elicited by food intake, in which a variety of clinical symptoms will appear as a result of physiological dysfunction and/or tissue damage. Possible mechanisms for food allergy include gastrointestinal tract barrier damage, failure to induce oral immune tolerance, intrauterine sensitization, and allergen transmission during pregnancy and breastfeeding. Hereditary and environmental factors can also contribute to the disease. Gastrointestinal disorders are the main clinical manifestations of the disease. However, hypoalbuminemia, growth retardation, and even acute circulatory failure or shock may occur in severe cases. Oral food challenges are the "gold standard" for the diagnosis of food allergy. Avoidance and replacement of the responsible food are the only effective treatment options for neonatal food allergy. The use of probiotics can offer protection against the disease.
Food Hypersensitivity ; classification ; diagnosis ; etiology ; therapy ; Humans ; Infant, Newborn ; Milk Hypersensitivity ; diagnosis ; etiology ; therapy

Objective To investigate the risk factors of low birth weight infants with food allergy.Methods Forty-nine food allergy children who had been admitted to the neonatal intensive care unit(NICU) of Peking University Third Hospital from Jan.1,2007 to Dec.31,2011 and followed up in the Pediatrics Allergy Clinic after discharged from hospital were involved as food allergy group.Forty-nine children who had been admitted to the NICU of Peking University Third Hospital at the same time and followed up in the Child Health Care Clinic after discharged from hospital but had no manifestations of food allergy were selected by stratified sampling as control group.A questionnaire was designed to record the children's gender,gestation age,mode of delivery,feeding patterns after discharging from hospital,tobacco and alcohol consumption of their parents,allergy history of their parents,the intake of egg of the mother during lactation and the children's introduction of egg.At the same time,their hospital notes were investigated.The diseases they had and the application of parental nutrition,pulmonary surfactant and ventilator were all analyzed.Quantitative data were analyzed with Chi-square,qualitative data were analyzed with t-test.The risk factors of food allergy of the low birth weight infants were examined by unconditional Logistic regression.Results The birth weight,gender,mode of delivery,feeding patterns after discharging from hospital,parents,exposure to tobacco smoke and alcohol,the intake of egg of the mother during lactation and the children's introduction of egg between the 2 groups were no significantly different.The diseases they got and the application of parental nutrition,pulmonary surfactant and ventilator when they in hospital were no significantly different,too.The gestation age,parental history of allergy between the 2 groups were significantly different.The proportion of children of 33-35 weeks and 36-37 weeks gestation age in food allergy group were significantly higher than those in control group,while the 29-32 weeks gestation age were significantly lower than those in control group (x2 =10.312,P =0.016 ;x2 =20.753,P =0.000).But by unconditional Logistic regression analysis,only the one or both parents,history of allergy was the risk factor for the development of food allergy of the low birth weight infants(OR =5.574,P =0.004;OR =14.487,P =0.000).Conclusion Parents history of allergy is related to the development of food allergy of the low birth weight infants.

OBJECTIVETo investigate the relationship of disease severity with angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and serum ACE activity in preterm infants during the first 7 days of life.

METHODSACE genotypes were determined in 85 preterm infants admitted to the neonatal intensive care unit (NICU). Serum ACE activity was measured and disease severity was evaluated by the Neonatal Critical Score (draft) 1, 3 and 7 days after birth.

RESULTSOf the 85 preterm infants, DD genotype was found in 19 cases, ID genotype in 34 cases and II genotype in 32 cases. On the 1st day of life, serum ACE activity in the DD genotype (33.42+/-7.93 U/L) and the ID genotype groups (31.53+/-7.56 U/L) were significantly higher than that in the II genotype group (25.53+/-7.56 U/L) (P<0.01). After 3 and 7 days of life, serum ACE activity decreased in the three groups, but the DD genotype group remained the highest ACE activity, followed by the ID genotype and the II genotype groups. On the 1st day of life, the critical score of the DD genotype group (87.37+/-8.30) was lower than the ID genotype (95.82+/-5.85) and the II genotype groups (95.88+/-6.85) (P<0.01). On the 3rd day, the critical score of the DD genotype group was still lower than the ID genotype group (92.95+/-7.10 vs 96.94+/-5.85) (P<0.05).

CONCLUSIONSACE gene I/D polymorphism may be associated with the disease severity in preterm infants. The DD genotype carriers present more severe disease status, with higher serum ACE activity. Although the disease status can influence serum ACE activity, serum ACE activity is determined by the ACE genotype.

Female ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Peptidyl-Dipeptidase A ; blood ; genetics ; Polymorphism, Genetic ; Time Factors

OBJECTIVETo study the relationship between Helicobacter pylori (Hp) infection and histopathological features of nodular gastritis (NG) in children.

METHODSA total of 213 children who had undergone gastroscopy due to upper gastrointestinal symptoms were enrolled and were divided into NG and non-NG groups according to endoscopic appearance. The histopathological features of gastric mucosa were evaluated using the updated Sydney System. The rates of Hp infection, moderate to severe inflammation and lymphoid follicles formation of gastric mucosa were compared between the two groups.

RESULTSThirty-eight (17.8%) of the subjects were diagnosed with NG. The NG group had significantly increased rates of Hp infection (86.8% vs 14.3%; P<0.01), moderate to severe inflammation (81.6% vs 15.4%; P<0.01) and lymphoid follicles formation of gastric mucosa (52.6% vs 10.3%; P<0.01) compared with the non-NG group. NG had a high specificity (96.8%) and a positive predictive value (86.8%) for the diagnosis of Hp infection. NG was observed in 33 (56.9%) of 58 Hp-positive children and in 5 (3.2%) of 155 Hp-negative children (P<0.01). Hp-positive children had higher rates of moderate to severe inflammation (86.2% vs 5.2%, P<0.01) and lymphoid follicles formation of gastric mucosa (84.2% vs 14.9% P<0.01) compared with Hp-negative children. There were significant differences in Hp colonization, degree of inflammation and inflammation activity in gastric tissues between the NG and non-NG groups (P<0.01).

CONCLUSIONSNG is a special sign of Hp infection in children, which mostly shows moderate to severe inflammation of gastric mucosa, and can be used as an endoscopic indicator of Hp infection. Hp eradication therapy should be considered in the treatment of NG.

Adolescent ; Child ; Child, Preschool ; Female ; Gastric Mucosa ; pathology ; Gastritis ; pathology ; Helicobacter Infections ; pathology ; Helicobacter pylori ; Humans ; Male