Objective To investigate the characteristic and clinical significance of airway inflammation in children with acute asth-ma. Methods Underwent sputum induction and sputum induction in children (n=34) with acute asthma was repented in recovered children ( n = 24).Induced sputum were also taken from 15 healthy children as controls.Total and differential cell counts were per-formed. Interleukin(IL)-8、IL-6 were measured,The relationship between inflammatory cells and IL-8、 IL-6、peak expiratory (PEF) were analyzed.Results The inflammatory cell infiltrate was mixed including eosmophilic granulocytes, neutrophils, and macrophages. They decreased significantly, but eosinophilic granulocyte remained a higher percentage compared with healthy subjects. There was low-er percentage of lymphocytes at acute exacerhation.Eosinophilic granulocytes were correlated with the degree of airflow obstruction. Levels of IL-8、IL-6 were elevated during the acute exacerbation and decreased at resolution.IL-8 was correlated significantly with neutrophils at acute exacerhation and resolution.IL-6 was correlated signifficantly with eosinophilic granulocytes at acute exacerbation. Conclusions Airway inflammation is chataeterized by infiltration of eosinophils, neutrophils and macrophages.IL-8、IL-6 possibly is the important cytokines of airway inflammation in children with acute asthma. Increased eosinophils in induced sputum correlates with asthma severity. Therapy to the cytokines may have potential values.J Appl Clin pediatr,2004,19(12): 1023-1025

Objective To discuss the clinical diagnostic method of postural orthostatic tachycarda syndrome(POTS) in children.Methods Thirty-six children with POTS were selected for the research.Among them 15 were boys,21 cases were girls.The age ranged from 5.9 to 16 years,average age 12.3 years.Among them 28 patients(78%) were in between 11-16 years.The age distribution,clinical courses and hemodynamic indexes were analyzed and also the incidence of clinical manifestations and investigation reports were observed.Results Among 81 patients of orthostatic regulation disturbance,36 patients were diagnosed POTS,which was 47% of total.The clinical courses ranged from 1 day to 5 years,average clinical course 10.2 months.The clinical courses of more than half of the total patients were within 6 months(56%).The common clinical features of POTS were chest tightness on standing,vertigo,fatigue,palpitation,syncope,orthostatic regulation disturbance.Ten patients were also associated with gastrointestinal symptoms like nausea,vomiting.The most common feature of POTS patients was tachycardia(HR increased by ≥30 times/min) within 10 min after head-up tilt test(HUT).Average HR increased by 38 times/min.In some patients HR increased up to ≥120 times/min.There were no significant changes in blood.In 23 cases(64%),the T waves were descended by ≥0.2 mV in 2 or more than 2 leads in ECG reading.Investigations reports showed that there were 12 cases whose urine specific gravity was increased.In 11 cases HCO_3~-decreased.Conclusions POTS is commonly seen in schooling female children.The common symptoms are vertigo,chest tightness,fatigue,palpitation.HUT is an important method for the diagnosis of POTS.

Objective To analyze blood lipid components in simple obesity children and to explore the effects of obesity in the lipid metabolism and its clinical significance.Methods A total of 90 children,including 50 simple obesity children(obesity group)and 40 normal children(control group),were enrolled in this study.The age ranged from 2.5 to 16.0 years.Their blood lipid profiles of all the children were analyzed.The blood lipid profiles were examined by biochemical analysis,including triglyeride(TG),total cholesterol(TC),low density lipoprotein(LDL) and high density lipoprotein(HDL),and the livers of all the children were analyzed.The blood lipid profiles were examined by ultrasonograph.Results 1.There were no significant differences in age and height in obesity group and control group,but there were significant differences in body mass index(BMI) and blood pressure(P0.05),which had no statistical meaning.3.Liver ultra sonogram showed that 18 cases had fatty liver(36%) in simple obesity children.Conclusions Metabolic disorder of blood lipid is present in simple obesity children,who have a tendency to get fatty liver.LDL is markedly elevated in obesity group.Arteriosclerotic cardiovascular disease should be prevented at earlier period of childhood.

Objective To explore the prevention and treatment effects of either antenatal corticosteroids (ACS) or postnatal pulmonary surfactant (PS) alone or the combination of both ACS and PS on neonatal respiratory distress syndrome (RDS). Methods One hundred and forty - three cases of RDS admitted to our neonatal intensive care unit ( NICU ) from Jan. 2003 to Jan. 2007 were selected, and divided into 4 groups:group 1 received both ACS and PS (n =36) ;group 2 only received ACS(n =33) ;group 3 only received PS (n =39) ;group 4 didn't receive both ACS and PS (n =35). The clinical parameters like sex,gestational age,birth weight,mode of dellvery,associated maternal risk factors, the Apgar score,the need of resuscitation at the time of delivery and associated perinatal complications of the babies were analyzed.The relation between the 4 groups regarding the different modes of supplemental oxygen use ( nasal prong and head box), continuous positive airway pressure (CPAP) ,the need of mechanical ventilator (MV) ,the mean NICU days to cure from the RDS and finally the treatment outcomes were compared. Results There were no significant differences between the 4 groups with regards to their general features and clinical parameters( P > 0.05 ). There was a significant difference between the groups regarding the mean hour requirement of the supplemental oxygen ( nasal prong and head box), CPAP and MV. Nasal prong : The mean hour for each group was ( 75.81 ± 15.63 ), ( 130.09 ± 27.32 ),(150.67 ±28.59) ,( 174.32 ± 25.92) h,respectively (P=0.041). Head box: The mean hour for each group was (37.16 ±5.51) ,(55.29 ±11.71 ), (62.69 ±12.39 ), ( 100.75 ± 28.10 ) h, respectively ( P = 0.047 ). CPAP: The mean hour for each group was ( 24.33 ± 4.41 ),(27.44 ±4.47), (26.53±3.13 ), (56.50 ± 5.50 ) h, respectively ( P = 0. 005 ). MV: The mean hour for MV use for each group was ( 56.12 ±15.65 ), ( 110.19 ± 21.59 ), ( 127.79 ± 26.36 ), ( 156.61 ± 12.92 ) h, respectively ( P = 0. 009 ). The mean number of days in NICU to recover for each group was ( 15.89 ± 1.29 ), (21.61 ± 2.30 ), ( 28.31 ± 3.40 ), ( 32.73 ± 4.57 ) d, respectively ( P = 0 ). The complete cure rate for each group was 63.89%, 51.52% ,35.90% ,20. 0% ,respectively. It shown a significant difference (P =0. 005 ) among the 4 groups regarding treatment outcomes. Conclusions ACS and PS combined therapy is the most effective therapy for the prevention of RDS,followed by ACS therapy alone,then PS therapy alone,and no ACS/no PS therapy is the least effective.

Objective To evaluate the effect of N- acetylcysteine(NAC) on lipopolysaccharide (LPS) - sensitized neonatal rats with hypoxic- ischemic brain damage(HIBD) and possible mechanism except the antioxidant. Methods With the total number of 98 Wistar pups at postnatal day 8 of either sex was used in this study. There were 86 pups which were divided into three groups to evaluate the brain injury:vehicle group ( n = 29) ,low dose (25 mg/kg) ( n = 31 ) and high dose NAC (200 mg/kg) ( n - 26) treatment group. The pups were injected with LPS(0.1 mg/kg)intraperitoneally 3 days before hypoxic- ischemic(HI) insult. Multiple dose of NAC (25 mg/kg or 200 mg/kg) or vehicle was injected intraperitoneally before and after HI. Brain injury was evaluated 7 days after HI. For the Caspase - 3 activity and immunoblotting analysis, the samples were collected at 24 h after HI treated either with vehicle or high dose NAC ( n = 6 per group). Results The brain injury volume was significantly reduced by high dose NAC (200 mg/kg) treatment compared with that of vehicle (77% reduction, P ＜ 0.001 ). The tissue loss was reduced 67 % ( P ＜ 0.001 ) in high dose NAC treated group compared with that of vehicle. However,there was no significant reduction of brain injury in the low dose NAC treatment group compared with vehicle group. Caspase - 3 like activity measurement showed that the activity decreased 53 % after high dose NAC treatment ( P ＜ 0. 001 ) compared with that of vehicle treatment. The immunoblots showed that the active form of Caspase - 3, 17 kDa band, was abolished by the high dose NAC treatment. Conclusions NAC treatment attenuate LPS - sensitized neonatal HI brain injury is dose dependent. The neuroprotective effect involves Caspase - 3 inhibition.

Objective To investigate the dose and time kinetics of induction of apoptosis induced by doxorubicin in J urkat leukemiacells, and to explore its pertinent molecular mechanisms. Methods Human Jurkat leukemia T - cells were treated with doxorubicin at theconcentration of 0.1 mg/L, 0.2 mg/L, 0.5 mg/L and 1.0 mg/L for 6,12,24 and 36 hours, respectively, of which one sample was pre-treated with zVAD- fmk (benzyloxycarbonyl - Val -Ala - Asp - fluoromethylketone) prior to addition of doxorubicin 0.2 mg/L. Apop-tosis was detected with both annexin V - FITC and propidium iodide ( PI ) staining and annexin V FITC and PI double positive cellswere analyzed by flow cytometry. Western blot was used to evaluate the level of Fas ligand (FasL) and FADD (Fas - associated death do-main) expression. Results The differences of apoptotic cells induced by all dose of doxorubicin were not significant (P＞0.05 ) at 6hour;at 12 hour, only the highest dose, 1 mg/L, significantly induced cell apoptosis;while the lowest dose,0.1 mg/L, did not significantlycaused cell apoptosis for all time points. After exposure to the doses of 0.2 and 0.5 mg/L for 24 or 36 hours,a significant increase in per-centage of apoptotic cells was observed (P ＜ 0.001 ). Apoptosis induced by doxorubicin was completely inhibited when the cells were incu-bated with doxorubicin in the presence of zVAD - fmk (P ＜ 0. 001 ). The level of FasL and FADD expression correspondingly increasedwith exposure time to doxorubicin. Conclusions Doxorubicin induces apoptosis in a dose - and time - dependent manner; upregulatedFasL may initiate the activation of the Fas signaling pathway and caspases are the ultimate executioner in the induction of leukemia cellapoptosis by doxorubicin.

Objective To explore incidence of child obesity in Zhengzhou area and intervention measures.Methods In 2001, spot check was conducted on 5688 cases of high and primary school students ,including 2848 boys and 2840 girls at the age of 7-18.Child obesity was diagnosed by meeting reference BMI value published by Cole et al,conducted comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment for 22 cases of simple obesity children (7-15 years old, 18 boys, 4 girls) selected for one month, and follow-up survey 6 months after treatment.Results Five thousands,six hundreds and eighty-eight high and primary school students investigated had an overweight incidence of 15.4%, an obesity incidence of 3.2%,boys' overweight incidence and obesity incidence(19.2%,4.6%) were remarkably higher than those of girls (11.5%,1.7% P<0.001). Overweight incidence of various age groups evidently differed(χ2=42.88 P<0.001) with the group of 8-15 years old children as popular. Incidence of various age groups also differed(χ2=21.28 P<0.05) with 7-10 years old and 14-15 years old children as popular. After one-month treatment, weight of all the 22 cases of fat children decreased from (76.45±19.87) kg upon hospitalized to (69.06±17.98) kg with a decrease of (7.43±2.58)kg, BMI value decreased from (31.05±3.96) before treatment to (27.72±3.54).Weight and BMI value before and after treatment differed evidently (t=13.6,12.88 P<0.01), and weight and BMI value decrease were remarkably related with those upon hospitalized (r=0.77 P<0.01;r=0.49 P<0.05).Conclusions Incidence of child obesity has been increasing in recent years, comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment have good curative effect and are comfortable, well received by children and suitable to promote and apply.

Objective To explore the effect of Bailing capsule on epithelial-mesenchymal transition( EMT) in rats with adenine-in-duced tubulointerstitial fibrosis. Methods Tubulointerstitial fibrosis animal models were established and SD rats were divided into mo-del group ( n = 30), treatment group ( n = 30) and control group( n = 30), randomly. Experimental rats were harvested at 7 w, 12 w,17 w after onset of experiment and functional evaluations were performed. Histology, immunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1 )and a-smooth muscle actin (α-SMA) in kidneys at three time points mentioned above, respectively. Results Compared with controlgroup, 24 h urinary protein in model group lost increasingly and significantly difference appeared at three time points relative to controlgroup ( P ＜ 0.01 ). Urinary NAG in model group was markedly higher than that in control group from 7 w after onset (P ＜ 0.01 ) andwas increasingly raised at 12 w and 17 w (P＜0.01). The value of blood BUN and Cr in model group increased at 7 w (P＞0.05) rel-ative to control group. There was significant difference at 12 w and 17.w (P ＜ 0.01 ). Histologically, kidneys in model group, at 7 w,exhibited tubular casts and gently tubular dilation, granuloma in cortex, mononuclear cells infiltration in tubulointerstitial areas, andmild interstitial fibrosis. At 12 w, the degree of tubular injury and tubulointerstitial fibrosis gradually aggravated. Up to 17 w, diffusetubular dilation or atrophy was observed and focal tubules disappear. Diffuse interstitial fibrosis was exhibited. In normal kidneys, im-munohistochemistry suggested that the light expression of BMP-7 was detected in proximal renal tubular epithelial cells and marked ex-pression was identified in distal tubule, collecting duct, and renal tubular epithelial in junction area between cortex and medulla. How-ever, the expression of BMP-7 in kidneys of model group significantly decreased with increasing tubulointerstitial fibrosis and was nega-tive correlation with the expression of TGF-β1(r = -0. 981 P＜0.01) and α-SMA (r= -0.975 P＜0.01). Bailing capsule ad-ministration protected the expression of BMP-7 and reduced TGF-β1 and α-SMA expression before 12 w(P＜ 0.01 ). Conclusions Ourstudy shows an anti-fibrotic reno-protective function of Bailing capsule in rats with tubulointerstitial fibrosis via prevention of epithelial-mesenchymal transition at early stage. However, the beneficial effect lost with increasing tubulointerstitial fibrosis.