Objective To investigate the effect of tumor necrosis factor-α(TNF-α)on cytokines expression in mice with different tidal volume(VT). Methods Thirty six SPF male BALB/c mice were randomly divided into three groups:A group(spontaneously breathed 4 h),S and L group(mechanically ventilated 4 h,VT=6 mL/kg and VT=20 mL/kg). The three groups were then randomly divided into two subgroups(C and T group,n=6). Mice in C group were injected with NS,while that of T groups were injected with TNF-α at 20 μg/kg from tail intravenous. Morphological manifestation was observed by hematoxylin and eosin staining. Ultrastructure of macrophages were examined by transmission electron microscopy. The expression of TNF-α,interleukin(IL)-1β,IL-6,IL-10 in serum and BALF were measured by ELISA. The expression of NF-κB mRNA and protein were detected by RT-PCR and WB,respectively. Results Compared with A and S group,following could be observed under light microscope in L group:the pulmonary interstitial edema,consolidation of part of the lung tissue,alveolar space fusion and a number of inflammatory cells infiltration. The expression of TNF-α,IL-1β,IL-6,IL-10 in serum and BALF,the expression of NF-κB mRNA and protein in macrophages of L group were significantly higher than those of A and S group(both P<0.05). The expression of these cytokines and NF-κB mRNA and protein were increased in T group (P < 0.05). The expression NF-κB is positively correlated with the expression of TNF-α,IL-1β and IL-6. Conclusion TNF-α is a key factor in inflammation of ventilation induced lung injury,which may provide a new method for prevention of VILI in clinical practice.

Objective: To analyze and identify the carotenoid in gingko seed.Methods: The chemical composition of the pigment from gingko seed was identified as carotenoid by UV absorption spectrum. Its content was determined by spectrophotometric method and its composition was analyzed and identified by thin-layer chromatography and HPLC method.Results: Gingko contained carotenoids, roughly about 489 ?g/100 g in which lutein, ?-carotene and ?-carotene amounted to 69.20%,15.80% and 7.45% respectively. Conclusion: Gingko contained large quantity of carotenoids, mainly lutein, and next in order ?-carotene and ?-carotene.

Objective To observe the effects of electro-acupuncture ( EA ) on learning, memory and the morphology of hippocampal neural tissues in rats with a model of chronic cerebral ischemia.Methods One hundred and twenty male Sprague-Dawley rats were used. Chronic cerebral ischemia models were successfully established in 104 of them, and those rats were randomly divided into an EA group and a model group with 52 rats each. These were further subdivided into 1,2, 4 and 6 week subgroups with 13 rats in each. The EA group was given EA. The changes in spatial learning and memory ability were observed using a Morris water maze. The morphological changes in hippocampal nerve tissue were observed by HE staining.Results The escape latency in the EA group was significantly different from the model group at the 2nd, 4th and 6th week. The nerve cells in the dentate gyrus were more tightly and consistently lined-up and had rich layers, and the structures in the EA group were better than in the model group.Conclusions EA can improve spatial learning and memory and promote the repair of injury after cerebral ischemia.

Objective To investigate the treatment and mechanism of aminoguanidine in retina of diabetic of rats .Methods To-tal 60 rats were divided into control group(n=20) ,diabetic group(n=20) and aminoguanidine treatment group(n=20)which would be treated by aminoguanidine for 14 days .Then the eye tissue of rats were took after 14 days administration for pathological obser-vation(HE staining) ,and the induced nitric oxide synthase(iNOS) ,endothelial nitric oxide synthase(eNOS) ,nerve type of nitric ox-ide synthase(nNOS) level and the expression of differences content and expression were investigated by ELISA ,Western blot and PT-PCR .Results HE staining showed that retinal tissue defects decreased and neuronal cells of rats in aminoguanidine treatment group were increased and significant (P<0 .05) compared rats in diabetic group .The iNOS content and expression of rats in amin-oguanidine treatment group were lower than diabetic group by ELISA ,Western blot and PT-PCR ,it was significantly difference (P<0 .05) and without significant difference between the normal group and diabetic group (P> 0 .05) .Compared with diabetes group ,iNOS ,eNOS ,nNOS protein expression in the rat retina in aminoguanidine treatment group were reduced (P< 0 .05) ,and without significant difference between the normal group and aminoguanidine treatment group (P>0 .05) .The iNOS mRNA expres-sion was lower than that of eNOS mRNA and nNOS mRNA in aminoguanidine treatment group .Conclusion Aminoguanidine can improve retinal tissue of diabetic rats with lesions ,the pathways may be selectively inhibit inducible nitric oxide synthase activity of iNOS .

Objective Hepatic artery (HA) reconstruction is one challenging procedure in pediatric liver transplantation (PLT).Here we review the first 115 microsurgical reconstructions of HA in PLT performed by a single surgeon,aiming to demonstrate the learning curve and the problems encountered.Methods From July 2016 to January 2017,a series of 115 microsurgical reconstructions of HA in PLT for end-stage liver disease were finished by one single surgeon with 4-year liver surgery experience and 2-week microsurgical training.HA reconstruction was performed with an operating microscope (Carl-Zeiss S88).Reconstruction was completed with interrupted sutures with 8-0 or 9-0 Prolene using the double clip for fixation.The blood flow was examined by Doppler scan daily after PLTs in first week and then once in 2nd week and first month for patency.A total of 143 artery anastomoses were performed in 115 PLTs.The age ranged from 3 months to 9 years.Indications for PLT included biliary atresia (105/115),Alagille syndrome (5/115),PFIC (3/115),Caroli disease (1/115),methylmalonicacidemia (1/115) and glycogen storage disease (1/115).Most of the PLTs were living donor liver transplantation (107/115),along with OLT (5/115) and split LT (3/115).Results The diameter of the arteries was mostly less than 2 mm (98/115).Up to date,one HA thrombosis (HAT) occurred at D8 after LT and 4 cases suspected as temporal HA stenosis (HAS) around 2 weeks after LT,which manifested as low velocity (<20 cm/s) and resistance index (<0.50) by Doppler.The HAT case failed in emergent re-anastomosis,but had a spontaneous recanalization at 3 weeks and is now in good condition without biliary problem.All the HAS children recovered to normal flows at first month.All children with HA complications started warfarin upon detection,with a targeted INR between 1.5-2.0.There were 6 deaths in this series including 5 cases of infections and 1 case of graft failure.Learning curve suggested a two phases growth (first 44 cases practicing phase vs.next 71 cases mature phase),which can be attributed to experience accumulation in terms of precise of manipulation,choice of inflow arteries for better match and stronger pulsation,avoidance of length redundant,prevention of kink.All the HAT and HASs happened in practicing phase while outcomes were excellent in mature phase.Moreover,time for each anastomosis was significantly shortened in second phase from 45-70 min to 30-55 min.Conclusion Microsurgical technique is highly safe in pediatric HA reconstruction,especially for very tiny arteries.It is possible to achieve low risk of complications for a new surgeon with adequate experience in liver surgery and microsurgical training.However,more surveillance and timing anticoagulation therapy is required before the mature of microsurgical technique.

Objective:To study the effects of hypertensive disorders of pregnancy (HDP) on the birth weight (BW) differences in twins.Method:From January 2011 to January 2020, twins delivered in our hospital were retrospectively analyzed. The twins born to HDP mothers were the HDP group and those born to healthy mothers were the control group. The maternal and neonatal data of the two groups were collected and the effects of HDP on the BW differences were analyzed.Result:The age of the mothers, the proportion of mothers of older ages and more-than-once delivery in HDP group (418 cases) were significantly higher than the control group (499 cases) [(31.4±5.3) years vs. (30.4±3.8) years, 26.6% (111/418) vs. 12.6% (63/499), 20.6% (86/418) vs. (15.0% (75/499)] ( P<0.05). The gestational age (GA) of newborns in the HDP group (836 cases) was significantly lower than the control group (998 cases) [(35.1±2.2) weeks vs. (36.7±1.2)]( P<0.05). The proportion of twins with GA <34 weeks in the HDP groups was significantly higher than the control group [24.2% (101/418) vs. 3.8% (19/499)] ( P<0.05). Cesarean section was the main delivery mode in both groups. The BW differences of the twins in the HDP group were larger than the control group [22.4% (9.1%, 31.9%) vs. 13.1% (5.8%, 19.6%)]. Significantly more twins in the HDP group showed ≥30% BW difference than the control group [28.7% (120/418) vs. 3.8% (19/499)] ( P<0.05). The incidences of BW discordant in twins (BWDT) in the HDP group was significantly higher than the control group [BWDT≥15%:61.5% (257/418) vs. 38.3% (191/499), BWDT≥20%: 51.4% (215/418) vs. 25.3% (126/499)] ( P<0.05).Among twins with GA of 34~37 weeks, the BW of the bigger infants and the smaller infants in the HDP group were all lower than the control group and the percentage of BW difference was significantly higher than the control group ( P<0.05). Conclusion:HDP may influence the intrauterine growth of the twins, aggravate the BW differences and increase the incidences of BWDT. It is necessary to make better prenatal management of HDP and closely monitor the intrauterine growth of the fetuses.

Objective: To develop a native adaptive behavior scale for children with autism spectrum disorder(ASD) and to explore its reliability and validity. Methods: Items of ASD adaptive behavior rating scale were selected based on the scale development theory, ASD knowledge and adaptive behavior concept through preliminary survey and statistical, and 301 ASD children aged 2 to 12 from hospitals in Guangzhou, Huizhou, Shenzhen who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition were selected, data was analyzed by the item analysis. Results: After item analysis and exploratory factor analysis, the final version of the scale contains 58 items, and 64.24% of the total variation could be explained by 6 factors; The Cronbach’s α coefficient of the full scale was 0.98, and the coefficient value of dimen sional factors were 0.94，0.93，0.91，0.95，0.88，0.94. The test-test reliability r of full scale was 0.86, the r of the factor were 0.88，0.81，0.81，0.87，0.88，0.79. The criterion-related validity r with the ABAS-Ⅱ scale was -0.77, the criterion-related validity r with the CARS scale was 0.64. Conclusion The ASD Child Adaptive Behavior Scale showed good reliability and validity, and could be used widely.

Objective To explore the diagnosis and treatment of parvovirus B19 infection-associated anemia after pediatric liver transplantation (LT) .Methods The clinical data were retrospectively reviewed for 2 children with severe anemia caused by parvovirus B19 infection after LT .Case 1 was a 2-year-old girl with a weight of 10 .7 kg .Classical orthotopic LT was performed due to ornithine carbamoyltransferase deficiency . Hemoglobin level began to progressively decline since Day 2 post-transplantation .And case 2 was a 5-month-old girl with an age of 5 months and a weight of 7 .2 kg .She underwent classic orthotopic LT for biliary atresia and decompensated liver cirrhosis .Hemoglobin level progressively declined at nearly 2 months post-transplantation . Results In case 1 ,bone marrow aspiration was performed at Day 54 post-transplantation .There was pure red cell aplasia and the detection of microvirus B19 nucleic acid was positive .Intravenous immunoglobulin was prescribed at a dose of 2 .5 g/day for 10 days ,tacrolimus was switched to cyclosporine and hemoglobin level spiked from 62 to 105 g/L after one-month treatment .In case 2 ,hemoglobin decreased to 44 g/L at 2 .5 months post-transplantation and the result of polymerase chain reaction of parvovirus B 19 was 9 .7 × 107 copies/ml .Then intravenous immunoglobulin was dosed at 2 .5 g/day for 10 days and hemoglobin level rose to 122 g/L at 25 days after treatment . Hemoglobin level decreased to 63 g/L again at 4 .5 months post-transplantation .Anemia was corrected by intravenous immunoglobulin injection plus a temporary discontinuation of tacrolimus and a reduced dose of tacrolimus .Conclusions Infection of parvovirus B19 can cause pure red cell aplasia after LT in children . Early diagnosis with intravenous immunoglobulin and modification of immunosuppressive regimen can obtain excellent therapeutic efficacies .

Objective To explore the experience of infantile liver transplantation ,reconstructing portal vein (PV) and avoid the higher incidence of portal vein low flow and complications .Methods The clinical data were reviewed for 152 infantile liver transplantations performed by a single surgery group .And 114 cases with PV risk factors underwent customized PV reconstructions .All of them were diagnosed as cholestatic liver diseases and 106 (93％ ) belonged to biliary atresia .Forty-two cases (36％ ) had 2 or more risk factors .Results Most cases (n= 106 ,93％ ) underwent living donor transplantations using lateral left graft while another 8 cases had deceased donor transplantations . Four types of PV reconstructions were adopted based upon individual conditions :left/right branch of PV trunk (n= 103) ,autogenous patch PV venoplastic reconstruction (n= 3) ,duct-to-duct of PV trunk (n= 5) and donor PV duct-to-recipient confluence of SMV/CV and SV (n= 3) .Graft size reduction was performed when GRWR > 4 .5％ (n= 16) .During a median follow-up period of 6 .5 (1 .5-13) months ,there were 3 LPVF (2 .6％ ) ,2PVS (1 .7％ ) and 1 PVT (0 .8％ ) .Three LPVF cases was corrected by PV stenting ,two cases of PVS were stable after anticoagulation therapy while one PVT case undergoing thromboectomy plus PV stenting resumed a normal PV flow .Conclusions PV reconstruction of high-risk infants require comprehensive risk evaluations ,precise surgical skills and customized strategies .For PV complications ,stenting is both safe and feasible .