Objective To investigate the clinical value of 3.0T magnetic resonance cholangiopancreatography (MRCP) in diagnosis of congenital biliary malformation in children.Methods Magnetic resonance imaging (MRI)and MRCP images,including the source image data and maximum intensity projection (MIP) reconstruction images,were analyzed retrospectively in 83 children with congenital biliary malformation diagnosed at Shanghai Children's Hospital,and their operative results and intraoperative cholangiopancreatography images were compared.Two experienced radiologists independently reviewed the images then they reached diagnostic conclusions by consensus.Eighty-three patients included 35 boys and 48 girls,aged from 20 days to 14 years.Results The MRCP indicated that 69 cases with choledochal cysts were consistent with intraoperative cholangiopancreatography findings,and the common bile duct showed different degrees of saccular and fusiform or columnar expansion with different types(Todani classification type Ⅰ 59 cases,type Ⅱ 1 cases,type Ⅳ a 7 cases,and type V 2 cases).The accuracy of localization and quality were 100％.MRCP demonstrated the anomalous junction of pancreaticobiliary duct in 14 cases.MRCP in 19 cases detected by intraoperative cholangiopancreatography with a sensitivity of 79％ and a specificity of 100％.Among 13 cases of biliary atresia,including 1 case accompanied with peritoneal organ inversion proved by MRI,11 cases of the entire extra—hepatic bile duct could not be completed visually,and 2 cases of small or small triangular signals were seen near the hepatic portal area,with the portal vein,and the left or right branches with 100％ accuracy of localization and quality including 1 case accompanied with peritoneal organ inversion proved by MRI.Congenital absence of gallbladder accompanied with duodenal obstruction was seen in 1 case,no gallbladder was found in the gallbladder fossa by MRCP,but the proximal duodenum was obviously dilated.Surgery confirmed that it was complicated and annular pancreas without gallbladder congenitally.Conclusion 3.0T MRCP is a noninvasive and effective method for diagnosis of congenital biliary malformation in children.It can be used as the preferred technique for diagnosis and long-term follow-ups.

Objective To investigate the methylation alteration of genomic DNA (gDNA) and its significance in pedigree neural tube defects (NTDs).Methods Twelve subjects from 3 NTDs pedigrees were enrolled in this study.NTDs patients were served as the case group,and their family members with normal phenotype were served as the control group.Peripheral vein blood was extracted,then gDNA was extracted.The extracted gDNA was treated with sodium bisulfite propagated as DNA segments in the way of whole genome amplification,which was put in I11umina Infinium human methylation 450k bead chip to perform hybridization,elution,extension,and imaging.The chip was scanned by iScan.Genome Studio was used to read the outcome.Illumina methylation analyzer software was used to analyze the methylation data.Results Gene differential methylation analysis showed that differential methylation sites only accounted for 0.2％ of the detected CpG sites and there were 617 differential hypermethylation sites (P ＜ 0.05),and 63 of them represented significant difference(P ＜ 1 × 10-4),including zinc finger E-box binding homebox 2,5,10-methylenetetrahydrofolate dehydrogenase 1 etc;there were 104 differential hypomethylation sites (P ＜ 0.05),and 65 of them represented significant difference (P ＜ 0.01),including Homeobox B7 and runt-related transcription factor 3 etc.Clustering analysis indicated that the tendency of DNA hypermethylation was consistent with NTDs patients,but the tendency of DNA hypomethylation was consistent with the controls.Conclusion In NTDs pedigree,the abnormal DNA methylation alterations may be the risk factor for NTDs occurrence.

Objective To explore the change of endogenous glucocorticoids (GC) secretion after intracranial hemorrhage (ICH) of neonatal rats and the impact of Dexamethasone (DEX).Methods Ten-day-old Sprague-Dawley rat pups of both sexes were randomized into 11 groups:normal control group(CON group),sham operated group (SHAM group),ICH group(each of which was further subgrouped into 12 h group,24 h group and 72 h group according to execution time after the modeled operation),glucocorticoids receptor (GR) agonist intervene group (DEX group) and GR antagonist intervene group(RU486 group).The intracranial autologous blood injection model of ICH was employed.Neurological functional deficits was measured by neurological deficit score (NDS),the levels of cerebral homogenate GC were tested by the emission immunology method,and the pathologic change and the expression of GR in hippocampus CA1 were examined by using Nissl staining and immunofluorescence separately.Results (1) Seventy-two-hour after the modeled operation,NDS of rats in the ICH group reached (7.48 ± 2.19) scores.After intervened by DEX,NDS of rats in DEX group decreased to (3.15 ± 1.93) scores,significantly lower than in ICH group,the difference was significant (P ＜ 0.05).The necrotic neurons were found around the hematoma of rats in ICH group,while in DEX group,less necrotic neurons were found.(2)In ICH group,the GC level in cerebral homogenate climbed up to a peak of (1.359 1 ±0.308 5) μg/L at 12 h,and slowly went down.By the end of 72 h,the GC level was (0.951 0 ±0.036 1) μg/L,which was higher than those of the CON group[(0.621 3 ±0.039 3) μg/L],the difference was significant (P ＜ 0.05),while in the DEX group,the level of GC in cerebral homogenate showed no difference with statistics from CON group.(3)The mean integrated optical density (IOD) of GR in hippocampal CA1 of rats in the ICH group (1.282 4 ± 0.035 6) were much more smaller than those in the CON group (1.012 5 ± 0.027 3,P ＜ 0.05),which meant the down-regulated expression of GR.(4) No difference was found in the NDS,pathological change,GC level and GR expression between RU486 group and ICH group.DEX didn't effect the expression of GR.Conclusions ICH in neonatal rat disturbs the modulation of hypothalamus-pituitary-adrenal axis,with an increase in the GC level and less GR expression.Early application of exogenous GC helps protect the neurons.

The medical workers are always facing great challenge when the influenza season comes every year,such as the variation of the virus strain,the occurrence of the high mortality complication and the reduced potence of the influenza vaccine.Meanwhile,the medical institution,as one of the most dangerous settings of the influenza outbreak,and the consequence could be deadly severe once it happened.So the aim of this manuscript is that,to review the knowledge regarding to influenza which is integrated with the newest research progress.On this basis,the manuscript goes into the influenza pandemic preventing strategy of medical institution in particular.

Nowadays severe influenza is still the main disease threatening the health of children.Influenza virus infection is mainly involved in the human respiratory system,the clinical manifestations are mainly respiratory symptoms,but the influenza virus can also cause systemic disease,especially in patients with severe influenza is often associated with multi system involvement.This paper will introduce influenza associated hemophagocytic syndrome,influenza associated encephalopathy,influenza associated viral myocarditis,influenza associated renal complications,influenza associated complications of digestive system,influenza associated rhabdomyolysis.

Influenza is caused by influenza virus.Neuraminidase inhibitors have produced certain effects for the management of influenza.Among them,Osehamivir has been in extensive use in adults and children,Peramivir and Zanamivir have been used in children.M2 inhibitors and traditional Chinese medicines can also be used in the management of influenza.In clinical practice,the physicians are expected to select anti-influenza drugs based on their mechanism of action and characteristics.

The prevalence of food allergy has increased in recent decades and the clinical focus on allergy has shifted from treatment to prevention. There have been dramatic changes of infant feeding guidelines on allergy preven-tion,especially the breastfeeding and the import of solid foods. In order to help clinician update their feeding know-ledge,the literatures related to infant feeding and food allergy have been retrieved and reviewed,and the prevention of food allergy has discussed.

Breast milk is best nutrition source for infants. However,human breast feeding is ceased or changed as formula feeding during disease or disease treatment. Now,the important significance of breast feeding for infants with preterm,diarrhea,jaundice,allergy,genetic disease and congenital cleft palate are analyzed,and feeding program is pro-vided,which can help mothers continue breast feeding and let the infants get nutritional support and protection from breast feeding. By breast feeding,it may improve children rehabilitation growth and development.

The formation of dietary behavior in infants and toddlers depends on healthy foods and the society -dietary behavior factors during the feeding process. Among them,one important society - dietary behavior factor is " reci-procity between child and caregiver(mainly,the parents)",which is the responsive feeding principle. In recent years, the research has found that in the early life,responsive feeding has positive effects on children′s nutrition,growth,cogni-tion,and social development. Responsive feeding should be accepted by more families,child care experts and nutrition experts. Now,the strategy that how to promote and practice responsive feeding in preterm infants and toddlers is re-viewed.

Children′s feeding behavior affects both their physical,mental and behavioral development,and fur-ther,it has important effects on children′s short - term and long - term health. Now,how to culture a good feeding be-havior for children,including the food choice,the meal time,the dining environment,parent - child interaction during feeding would be introduced.