OBJECTIVE: To evaluate the therapeutic effect and safety of letrozole in the treatment of adolescent boys with idiopathic short stature (ISS). METHODS: A retrospective analysis was performed for the clinical data of 16 adolescent boys with ISS who had a bone age of ≥14 years. Among these boys, 8 were initially treated with recombinant human growth hormone (rhGH), followed by rhGH combined with letrozole during a bone age of 14-15.5 years. The other 8 boys were initially treated with rhGH combined with letrozole since their bone age was ≥14 years at diagnosis. Of the 16 boys, 16 were treated for not less than 6 months, 12 were treated for not less than 1 year, and 5 were treated for not less than 1.5 years. The increase in bone age, predicted adult height (PAH), final adult height, sex hormones, and adverse reactions after treatment were analyzed. RESULTS: After 6 months, 1 year, and 1.5 years of treatment, median bone age was increased by 0 year, 0.5 year, and 0.5 year respectively, which was significantly lower than the increase in age (P<0.05). There was a significant increase in PAH after treatment (P<0.05). Seven boys reached final height, which was significantly higher than PAH before treatment (P<0.05). All the 16 boys had significant increases in luteinizing hormone, follicle-stimulating hormone, and testosterone levels after treatment (P<0.05), with a significant reduction in the estradiol level and a significant increase in the insulin level at 1 year of treatment (P<0.05). There was a significant increase in the insulin-like growth factor-1 level at 6 months and 1 year of treatment (P<0.05). There were no significant changes in blood glucose, blood lipids, uric acid, and the three indices for thyroid function as monitored during treatment (P>0.05). CONCLUSIONS In adolescent boys with ISS and a high bone age, rhGH combined with letrozole can safely and effectively delay the increase in bone age and improve PAH and final adult height, with little adverse effect.
Adolescent ; Body Height ; Dwarfism ; Growth Disorders ; Human Growth Hormone ; Humans ; Letrozole ; therapeutic use ; Male ; Retrospective Studies

A 14-year-old female (social gender) patient was admitted to the hospital due to severe hypertension for 11 days. The patient had primary amenorrhea. The blood pressure was 146/90 mm Hg. The skin color was slightly black. The development of secondary sexual characteristics was poor. The labia majora could be observed in the vulva. However, the labia minora, clitoris, vagina, and hymen were absent. The levels of renin, cortisol, and sex hormone were low, while the levels of adrenocorticotropic hormone and gonadotropin were high. The levels of blood potassium and aldosterone were both normal. Radiography indicated retardation of bone age. Ultrasound examination revealed that the ovary and uterus were both absent. The patient had bilateral adrenal hyperplasia and cryptorchid testes located in both inguinal canals. The patient had a 46,XY karyotype. Whole genome sequencing revealed two homozygous mutations, c.985T>C and c.987delC, in exon 6 of the CYP17A1 gene of the patient and heterozygous mutations in the same sites of the parents. The patient was diagnosed with congenital adrenal hyperplasia-17α-hydroxylase deficiency. After treatment with hydrocortisone for 2 months, blood pressure returned to normal and the level of adrenocorticotropic hormone was reduced. According to the request of the patient and the parents, hydrocortisone was replaced with estrogen to allow the patient to live as a female. The patient also received surgical excision of cryptorchid testes to prevent gonadal malignancy. It is concluded that in the differential diagnosis of pediatric hypertension, sexual development should be considered and the levels of adrenocorticotropic hormone and cortisol should be evaluated. The rare disease 17α-hydroxylase deficiency should be considered for patients with low-renin hypertension and gonadal dysgenesis.

OBJECTIVETo investigate the status of pubertal development in children born with assisted reproductive technology (ART).

METHODSA retrospective analysis was performed on the pubertal development data of children born with ART in Peking University Third Hospital from 1994 to 2003 (ART group). The data in the cross-sectional study "Reports on the Physical Fitness and Health Research of Chinese School Students in 2010" were used as a control. The age at menarche and the age at spermarche were compared between the two groups. The status of pubertal development in the overweight and obese children in the ART group was evaluated to investigate the correlation between pubertal development and body mass index (BMI).

RESULTSA total of 200 children born with ART were enrolled in this study, and 72 of them (41 males and 31 females) completed the survey (response rate=36.0%). In the ART group, the mean age at spermarche and the mean age at menarche were 13.9 years (95%CI: 13.7-14.3 years) and 12.2 years (95%CI: 11.8-12.6 years), respectively. There were no significant differences in the age at spermarche and the age at menarche between the ART and control groups (P>0.05). In the ART group, there were no significant differences in the age at spermarche and the age at menarche between the overweight and obese children and the normal weight children (P>0.05). There were also no significant differences in overweight rate and obesity rate between the children in the ART group and the adolescents in Beijing (P>0.05). In the ART group, there was no significant correlation between the age at spermarche or menarche and BMI (P>0.05).

CONCLUSIONSNo delayed or precocious puberty is observed in children born with ART. This is consistent with the normal control data. And there is no significant correlation between pubertal development and BMI in children born with ART.

Adolescent ; Body Mass Index ; Child ; Child Development ; Cross-Sectional Studies ; Female ; Humans ; Male ; Menarche ; Obesity ; physiopathology ; Overweight ; physiopathology ; Puberty ; physiology ; Reproductive Techniques, Assisted ; Retrospective Studies

OBJECTIVETo study the characteristics of R bone age, C bone age, and T bone age in children with different causes of short stature based on the Tanner and Whitehouse skeletal age assessment system 2 (TW2), and to provide a reference for the etiological diagnosis of short stature.

METHODSThree hundred and sixty-three children with previously untreated short stature were classified into four groups according to the causes: growth hormone deficiency (GHD; 27 cases), idiopathic short stature (ISS; 280 cases), small for gestational age (SGA; 41 cases), and Turner syndrome (TS; 15 cases). The X-ray films of their left hand-wrist bones were taken to determine the bone age. R bone age, C bone age, and T bone age were assessed by the TW2 method and compared with their chronological age (CA).

RESULTSR bone age, C bone age, and T bone age were over 2 years less than CA in both boys and girls from the GHD group. In the ISS group, R bone age, C bone age, and T bone age were about 1 year less than CA in boys, while there were no significant differences between the bone ages and CA in girls. In the SGA group, there were no significant differences between the bone ages and CA in either boys or girls. In the TS group, R bone age and T bone age were significantly lower than CA, while there was no significant difference between C bone age and CA.

CONCLUSIONSThe children with different causes of short stature have different characteristics of R bone age, C bone age, and T bone age assessed by the TW2 method. The assessment of R bone age, C bone age, and T bone age by the TW2 method is helpful for the etiological diagnosis of short stature in children.

Adolescent ; Age Determination by Skeleton ; Body Height ; Child ; Female ; Growth Disorders ; diagnosis ; etiology ; Humans ; Male

Atrial Flutter ; diagnosis ; drug therapy ; physiopathology ; Female ; Humans ; Infant, Newborn ; Male

Objective:To compare the effect of TiO 2 nanoparticles on antioxidant function and element content of liver and kidney tissues in young and adult rats .Methods:Forty-eight SD male rats , half in 4-week (youth) old and half in 9-week (adult) old rats, were randomly divided into 8 groups, which were exposed to TiO2 nanoparticles [(75 ±15) nm, anatase] through intragastric administration at 0, 10, 50 and 200 mg/kg body weight every day for 30 days.The liver and kidney tissues were collected for antioxidant function and element content analysis .Results: 200 mg/kg TiO2 nanoparticles exposure significantly increased the liver total superoxide dismutase ( T-SOD ) activity and the kidney reduced glutathione (GSH)/oxidized glutathione (GSSG) ratios in young rats, and significantly decreased the liver Mo, Co, Mn and P contents and the kidney Rb and Na contents in young rats .200 mg/kg TiO2 nanoparticles exposure significantly increased GSH/GSSG ratios and Rb contents and decreased Na con-tents in the liver of adult rats .No significantly difference was found in antioxidant indexes and elements content in the kidney of adult rats between three experimental groups and control group .Conclusion:TiO2 nanoparticles can enhance the antioxidant capacity and decrease the elements content in rat liver and kidney tissues .The liver is the more sensitive target organ and the young animals are more susceptible to TiO2 nanoparticles toxicity by the oral routes .

Objective To assess the efficiency of synchronized nasal intermittent positive pressure ventilation (SNIPPV) as a transitional mode in treatment of neonatal respiratory distress syndrome (RDS) after extubation.Methods In this single-center and randomized controlled trial,preterm infants (gestational age less than 35 weeks)with RDS who received mechanical ventilation were randomly assigned to receive SNIPPV(33 cases) or NCPAP(34 cases) after extubation.Blood gas analysis,prevalence of extubation failure and complications were compared between the 2 groups.Results The Pa (O2) in SNIPPV group was significantly higher but the pa (CO2) was significantly lower than those in the NCPAP group at 3 h and 12 h after extubation respectively(all P ＜ 0.05).Infants treated with SNIPPV had a decreased incidence of hypoxemia,hyperbicarbonatemia and extubation failure compared with those of patients treated with NCPAP (all P ＜ 0.05).SNIPPV group had a decreased incidence of apnea (P =0.000),shorter duration of mechanical ventilation and oxygen treatment duration than those of NCPAP group (all P ＜ 0.05).Conclusions SNIPPV is superior to NCPAP in serving as a transitional mode after extubation for preterm infants with RDS,and should be used in preference after extubation.

OBJECTIVETo explore the effect of titanium dioxide (TiO₂) nanoparticles on hemogram in rats with gastric ulcer.

METHODSPhysicochemical properties of TiO₂ nanoparticles were characterized. Twenty-four clear class SD male rats, aging 8 week-old, were randomly divided into 4 groups, 6 rats for each group. 20% acetic acid were injected into the rats' stomach on the border of gastric body and pyloric antrum, and hereby established the gastric ulcer model. The rats in 4 groups were exposed to TiO₂ nanoparticles through intragastric administration at 0, 10, 50 and 200 mg/kg body weight respectively for 30 days. Afterwards, the rats were conducted blood routine test and blood coagulation test for analysis.

RESULTSTiO₂ nanoparticles were anatase crystals, closely spherical shape, whose average grain diameter was (75 ± 15) nm. The levels of white blood cell (WBC) count ((8.48 ± 3.28)×10⁹/L), lymphocyte (LYM) ((6.85 ± 2.53)×10⁹/L), monocyte (MOD) ((0.27 ± 0.12)×10⁹/L), granulocyte (GRN) ((1.37 ± 0.86)×10⁹/L), red blood cell (RBC) ((8.20 ± 0.49)×10⁹/L) and hematocrit (HCT) ((45.3 ± 1.4)%) in the 200 mg/kg dose group were significantly higher than those in the control group ((2.63 ± 0.34)×10⁹/L, (2.25 ± 0.26)×10⁹/L, (0.05 ± 0.06)×10⁹/L, (0.33 ± 0.26)× 10⁹/L, (4.87 ± 2.37)×10⁹/L and (27.2 ± 13.3)%, respectively; t values were -3.449, -3.825, -3.554, -3.097, -2.972 and -2.936 respectively, P values all < 0.05). The levels of WBC ((6.88 ± 3.06)×10⁹/L), MOD ((0.20 ± 0.07)×10⁹/L), RBC ((7.79 ± 0.48)×10⁹/L) and HCT ((42.7 ± 2.8)%) in 50 mg/kg dose group were also statistically higher than those in the control group (t values were -2.507, -2.367, -2.605 and -2.511 respectively, all P values < 0.05). There was no statistically difference found in other blood routine index and coagulation index between the three experimental groups and control group.

CONCLUSIONThe long term intake of TiO₂ nanoparticles caused a statistically increase in the amount of WBC and RBC in rats with gastric ulcer; however, there was no obvious changes found in blood platelet and coagulation index.

Animals ; Hematologic Tests ; Male ; Metal Nanoparticles ; adverse effects ; Rats ; Rats, Sprague-Dawley ; Stomach Ulcer ; blood ; Titanium ; adverse effects

OBJECTIVETo evaluate the clinical features of respiratory diseases of late preterm neonates.

METHODSSix hundred and thirty late preterm infant(gestational age: 34~36+6weeks),4401 cases of term infants and 328 early preterm infants who were born at the obstetrical department of Peking University 3rd Hospital from January 2009 to December 2010 were enrolled. Among them 84 late preterm infants, 135 term infants and 182 early preterm infants developed respiratory diseases. The incidence of respiratory diseases,clinical features and the severity of the diseases were compared among the three groups.

RESULTSThe incidence and mortality rates of respiratory diseases and the percentage of severe cases were significantly higher in the late preterm group than in the term group, but lower than in the early preterm group (P<0.01). The symptoms of respiratory disease occurred earlier in the late preterm group than in the term group, but later than in the early preterm group (P<0.01). The late preterm group had a significantly higher incidence of tachypnea and lower incidence of retraction sign when compared with the term and early preterm groups (P<0.05). The percentages requiring oxygen therapy and mechanical ventilation in the late preterm group were both significantly higher than in the term group, but lower than in the early preterm group (P<0.05). The multiple linear regression analysis showed 11 factors associated with the severity of respiratory diseases: decreased arterial partial pressure of oxygen, hematokrit, pH value and respiratory rate, arterial oxyhemoglobin saturation, systolic arterial pressure, 5 minute Apgar score and gestational age, and increased blood urea nitrogen, heart rate and respiratory rate.

CONCLUSIONSLate preterm infants are more likely to develop respiratory diseases than term infants, and to develop a more severe condition and need a more intensive respiratory support treatment. Tachypnea is a common presentation of dyspnea in late preterm infants and occurs earlier than in term infants but later than in early preterm infants. It may usually indicate a serious condition when dyspnea, abnormal heart rate and blood pressure, and multisystem damages occur in late preterm infants.

Humans ; Incidence ; Infant, Newborn ; Infant, Premature, Diseases ; epidemiology ; mortality ; Prognosis ; Respiratory Tract Diseases ; epidemiology ; mortality ; Retrospective Studies

Objective To explore the effect of Potent Purgative Decoction with Additions on the treatment and nursing intervention of adhesive ileus.Methods Totals of 152 patients with adhesive ileus were randomly divided into observation group and control group with each group 76 cases.Western-style medical treatment was adopted in the control group,while combined Western-style medical treatment with Potent Purgative Decoction with Additions was adopted in the observe group.Results The total effective rate of observe group was 93.42％ significandy higher than 78.95％ of control group(x2 =8.876,P =0.012).Conclusions Potent Purgative Decoction combines with Additions is an effective method to treat adhesive ileus,and which is propitious to recuperate the gastrointestinal function and shorten the length of stay.