0.05).Conclusion Breath-hold MRCP utilizing the SSFSE technique with high-quality images can accurately assess the level of obstruction and the causes of the obstruction in patients with obstructive jaundice, without the risks of endoscopic retrograde cholangiopancreatography(ERCP).This MRCP technique should be preferred a reliable and noninvasive imaging modality for the diagnosis of obstructive jaundice.

In order to learn the tissuse perfusion and oxygenization in the patient with septic shock (SS) in Qinghai plateau,25 cases having suffered from SS in Xining,the capital of Qinghai province, were divided into death group (group D) and survival group(group S), and the data of oxygen dynamics, determined by Swan-Ganz cathter and thermodilution methods,were analyzed retrospectively. The results showed that the oxygen delivery (DO_2) and oxygen consumption (VO_2) increased to varying degrees in all of cases;VO_2 was positively correlated with DO_2, and in group D the correlation remained significant during whole duration of disease,but in group S it became unsignificant as DO_2 was above 700 ml?min~(-1)?m~(-2); the oxygen extraction rate decreased markedly in both groups,but much more in group D. These suggest that the insufficient oxygenization of general tissuse in patient with SS results from the dysfunction of oxygen extraction,and increasing DO_2 is helpful for the shock resuscitation except VO_2 is persistently and positively correlatded with DO_2.

Objective To study the mechanism of interaction between neuronal nitric oxide syn-thase (nNOS) and inducible nitric oxide synthase (iNOS) following traumatic brain injury (TBI) in rats. Methods A total of 250 male Wistar rats were randomly divided into five groups, ie, sham oper-ation group, trauma group, 7-nitroindazole (7-NI) treatment group, aminoguanidine (AG) treatment group and combined AG and 7-NI treatment group. Severe closed TBI was made by using Marmarou meth-od. Protein expressions of nNOS and iNOS in hippocampus CAI were detected by means of immunohisto-chemical staining at 1,3, 6, 12 hours and at days 1,3, 7 and 14 after TBI. Results The expression of nNOS reached a peak at 6 hour after injury in all groups, with no statistical difference between groups (P > 0. 05), when there was no statistical difference between 7-NI treatment group and trauma group (P > 0. 05) but statistical difference in AG treatment group and combined AG and 7-NI treatment group compared with trauma group at 12 hours after TBI (P <0.05). The expression of iNOS reached maximal level at day 3 after TBI, with lower level in 7-NI group, AG treatment group and combined AG and 7-NI treatment group compared with trauma group (P < 0.05). Conclusions After TBI, nNOS interacts with iNOS by means of the feedback of nitric oxide. The enhanced expression of nNOS is initial factor for increase of iNOS expression, which can down regulate the expression of iNOS.

Objective To analyze the changes of celluar and humoral immunity in children with juvenile idiopathic arthritis(JIA),as well as the changes in different subtypes,and to investigate the role of cellular and humoral immunity in the pathogenesis of JIA.Methods Ninety-two JIA subjects and 82 controls(healthy children) were included into this study.The levels of T lymphocyte subsets,natural killer (NK)cells,and B cells were analyzed by using flow cytometry.The serum interleukin-1 (IL-1),tumor necrosis factor-α (TNF-α),interleukin-l0 (IL-10),transforming growth factor-β(TGF-β) levels were detected by using enzyme-linked imnmunosorbent assay (ELISA).The serum IgG,IgM,IgA and C3,C4 levels were detected by using velocity scatter turbidimetry.Independent t-test,One-Way ANOVA test and Pearson analysis were adopted for data analysis.Results 1.In the group of JIA,the levels of CD3,CD4,IL-1,TNF-α,IgG,IgM,IgA and C3 were higher than those in the control group(all P ＜ 0.05),while the levels of CD4CD25,CD8,NK cells,IL-10 and TGF-β were lower than those in the control group(all P ＜0.05),and the ratio of CD4/CD8 was higher than that in the control group (P ＜ 0.05).2.In the group of systemic-onset JIA (so-JIA),the levels of CD4,IL-1,TGF-β,IgG,IgM,IgA,C3 and the ratio of CD4/CD8 were higher than those in the oligoarthritis JIA group(all P ＜ 0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group(all P ＜ 0.05).In the group of polyarthritis JIA,the levels of IL-1,TNF-α,IgG,IgM and IgA were higher than those in the oligoarthritis JIA group(all P ＜0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group (all P ＜ 0.05) ; In the group of so-JIA,the levels of CD4,TGF-β,C3 and C4 were higher than those in the polyarthritis JIA group (all P ＜ 0.05).3.The value of IL-1,TNF-α were positively correlated with that of C-reactive protein (CRP),erythrocyte sedimentation rate(ESR) in the JIA group(all P ＜ 0.05),while the value of IL-10,TGF-β was negatively correlated with that of CRP,ESR(all P ＜ 0.05).Conclusions There are cellular immunity and humoral immunity disorders in the JIA.Cellular immunity and humoral immunity are all involved in the pathogenesis of JIA.T helper cells are activated and Th1 cytokines increase,suppressive T cells,regulatory T cells impairment and suppressive cytokines decrease but immunoglobin increase,which involve in auto inflammation reaction and articular destruction in JIA.The immunity disturbances are more striking in so-JIA and polyarthritis JIA.IL-1,TNF-α,IL-10 and TGF-β are correlated with the disease activity.

Objective To investigate the safety and efficacy of reducing pulmonary arterial pressure in patients with congeni‐tal heart disease(CHD) complicated with pulmonary hypertension(PAH) .Methods From September 2014 to January 2015 in our hospital ,34 patients with CHD complicated with PAH were selected ,all of them were treated with endothelin receptor antagonist , bosentan ,on the basis of conventional therapy .The hemodynamics observation ,cardiac function detection and six‐minute walking distance test(6 MWD)were performed after pulmonary artery pressure reducing therapy .Results After treatment ,the pulmonary vascular resistance (PVR) ,arterial oxygen saturation(SaO2 ) ,Qp/Qs and right cardiac output(CO) in these patients was (218 .30 ± 91 .25)dyn · s-1 · cm -5 ,(95 .16 ± 7 .84)% ,(1 .10 ± 0 .27) and (5 .20 ± 1 .36) L/min ,respectively ,which were better than those be‐fore treatment(P<0 .05) .There was no statistically significant difference in the pulmonary artery systolic pressure(sPAP) ,pulmo‐nary artery diastolic pressure pulse AI(dPAP) ,mean pulmonary arterial pressure(MPAP) ,heart rate(HR) and central venous pres‐sure(CVP) before and after the treatment(P>0 .05) .There was no statistically significant difference in the right ventricular diame‐ter(RVD) ,left ventricular ejection fraction(LVEF) ,three tricuspid regurgitation velocity(VP) ,three tricuspid valve transvalvular pressure difference(PGTV) ,left ventricular diastolic volume (LVEDV) and left ventricular diastolic diameter(LVEDD) before and after the treatment(P>0 .05) .After 3 months and 6 months of treatment ,6 MWD was (378 .09 ± 40 .12) and (423 .07 ± 35 .32) m respectively ,both of which were higher than those before treatment ,the differences were statistically significant (P<0 .05) .Conclu‐sion The application of bosentan therapy is safe and effective for patients with CHD complicated with PAH ,which could improve pulmonary hemodynamics and 6 MWD .

Objective:To investigate the relationship between CD 4+CD25+regulatory T cells ( Treg) and monocyte chemoat-tractant protein-1 and its mechanism in KD pathogenesis .Methods:48 patients of KD (28 cases of recovery ,20 cases of acute phase ) were admitted from June 2014 to June 2015 and the other 40 cases of healthy children was admitted to control group .The levels of serum interleukin-15,17,23 (IL-15,17,23) and MCP-1 of two groups were measured with ELISA.The levels of Treg/Th17 cell ratio of two groups were measured with flow cytometry .Results:The levels of IL-15,IL-17,IL-23 and MCP-1 of KD group were higher than control groups(P<0.05) and the levels of IL-15,IL-17,IL-23 and MCP-1 of acute phase groups were higher than recovery groups .The levels of Th17,Treg cells,Th17/Treg of KD group were lower than the control group (P<0.05),while the levels of Th17,Treg cells,Th17/Treg cells in the acute phase of KD patients were higher than stable phase .The levels of IL-15,IL-17,IL-23 and MCP-1 and Treg/Th17 were negative correlation with univariate analysis by Pearson (P<0.05).Conclusion:The imbalance between Treg and Th17 cells and MCP-1 levels continue to rise may be associated with KD onset and progress of the disease is closely related to children in KD vivo by meas -uring children with KD Treg/Th17 cells and MCP-1 ratio of assessment Children with the condition and prognosis has some signifi-cance.

Objective To observe the changes in red cell distribution width (RDW)and plasma N -terminal pro -brain natriuretic peptide(NT -proBNP)in children with chronic heart failure due to congenital heart disease (CHD),and to investigate their correlations with cardiac function.Methods Eighty -four children with chronic heart failure and pneumonia secondary to CHD who were hospitalized in Wuhan Health Care Center for Women and Children from January to December 201 4 were enrolled.According to the modified Ross scoring system,they were divided into 3 subgroups:mild,moderate and severe heart failure subgroups.Forty -five children with pneumonia who were hospitali-zed during the same period were randomly selected as the control group.Then the levels of RDW and plasma NT -proBNP were compared in each group,and the correlation between RDW and NT -proBNP was analyzed.Results The levels of RDW and plasma NT -proBNP in children with heart failure caused by CHD were significantly higher than those of the control group[(1 5.6 ±2.2)% vs (1 3.7 ±1 .5)%,(3 252.9 ±1 061 .5)ng/L vs (67.4 ±1 7.9)ng/L, t =5.51 8,7.838,all P <0.01 ].NT -proBNP levels were gradually increased along with increasing heart failure grade, and there were statistically significant differences[(1 71 8.3 ±456.2)ng/L vs (3 371 .4 ±834.2)ng/L vs (4 681 .2 ± 1 21 4.8)ng/L,F =1 5.961 ,P <0.01 ].RDW levels also increased gradually,while there were no statistically signifi-cant differences[(1 5.2 ±1 .5)% vs (1 5.7 ±2.0)% vs (1 6.0 ±2.8)%,F =2.246,P >0.05].There was no signifi-cant correlation between RDMand NT -proBNP (r =0.1 34,P >0.05).Conclusions For children with CHD,higher RDW and NT -proBNP levels can aid in the diagnosis of chronic heart failure,and NT -proBNP level is associated with the severity of heart failure,yet it is still unclear whether RDW level can reflect the severity of heart failure.

Objective To explore the function of autonomic nerves system in children with congenital heart disease (CHD) combined with paroxysmal supraventricular tachycardia (PSVT). Methods Fifty children having PSVT and no CHD (PSVT group), 30 children with both PSVT and CHD (CHD group), and 50 cases of healthy children (control group) were selected. The difference of 24-hour heart rate variability (HRV) among three groups was analyzed retrospectively. Results There were statistical differences in the long-range time domain HRV indexes, including SDNN, SDANN, SDNN Index, pNN 50 , and RMSSD among three groups (F=80.32-?263.18, P all??0.05). The SDNN, SDANN, SDNN Index, pNN50, and RMSSD were signiifcantly decreased in CHD group compared with PSVT group (P all?

AIM To determine the dynamic changes of monoamine neurotransmitters and their metabolites in various brain regions of cerebral ischemia reperfusion mice. METHODS Concentrations of monoamine neurotransmitters such as norepinephrine (NE), dopamine (DA), serotonin (5-HT) and metabolites were determined by HPLC-ECD on d 0,1,3,5 and d 20 after cerebral ischemia reperfusion by common carotid artery occlusion. RESULTS The cerebral ischemia reperfusion mice showed decreased concentrations of NE, MHPG, DA, DOPAC, 5-HT and 5-HIAA in various brain regions, especially in hippocampus. CONCLUSION Several neuron systems play an important role in neurons damage of cerebral ischemia reperfusion, especially the NE and DA in hippocampus which is sensitive to the ischemia damage. The data offer useful guides for clinical treatments of cerebral ischemia diseases.