1263 children aged 3-6 years old in Wuxi city were included.Overweight 191 children were overweighte,104 obese and 968normal.SPSS analysis showed that deciduous teeth caries and age were positively relative (F=31.77,P=0.0001);obesity and age were not relative(x2 =36.00,P=0.33);deciduous teeth caries and obesity were not relative (F =0.21,P =0.808).Deciduous teeth caries is not related with obesity.

Objective To study the expression of DDH and VEGF in esophageal carcinoma and their relationship, and their prognostic significance for patients of esophageal carcinoma.Methods The expression of DDH and VEGF in 61 esophageal carcinoma tissues and border areas were detected by immunohistochemistry SABC method.Results The positive rate of DDH and VEGF in esophageal carcinoma tissues are higher than those in border areas,both of their expression were correlated with TNM stages,grades of cell differentiation and lymph node metastasis.Patients expressing DDH and VEGF seemed to have a poor prognosis.The expression of DDH was found in a positive correlation with VEGF. Conclusion DDH and VEGF were correlated with the tumorigenesis and progression of esophageal carcinoma patients.

Objective To investigate the causes, clinical features, treatment and prognosis of gastrointestinal bleeding (GIB) patients in emergency department.Methods To analyze prospectively the clinical data of 168 GIB patients admitted to the emergency department of Peking Union Medical College Hospital during 2006.1-2006.12.Results (1) General data; male: female = 1.75:1 ( 107: 61) , mean age 13-87(56.5 ±17.8) years with a peak in 60-69 years.The percentage of old patients was significantly higher than that of young and middle age ( 52.4% vs 19.6% and 28.0% , P = 0.000 ).( 2 ) The incidence of acute gastric mucosal lesion in patients taking non-steroidal antiinflammatory drugs ( NSAIDs) ( 18.5% ) was significantly higher than that in patients not taking( 0.7% , P = 0.000 ).( 3 ) 86.9% ( 146/168 ) of the patients had anemia.(4) More patients who took emergency gastroscopy could be diagnosed than those patients who did not (89.4% vs 58.5% , P =0.000), while no significant difference could be seen between patients who took emergency enteroscopy and patients who had non-emergency gastroscopy (20.0% vs 57.9% , P =0.315).(5)The hemostatic ratio in GIB patients due to peptic ulcer was obviously higher than that in GIB patients due to other causes (86.0% vs 40.7% ,P =0.000).The rate of emergency operation for GIB patients was 1.8%.Conclusions Most of the GIB patients admitted to tertiary general hospitals are elderly males.NSAIDs administration is one of the most important causes of upper GIB.Upper GIB patients should have gastroscopy as soon as possible, while emergency coloscopy is of little significance in cases with lower gastrointestinal hemorrhage.

Objective To evaluate the clinical application value of fluorescence PCR melting curve method in the drug-resistance detection of Mycobacterium tuberculosis.Methods With the Lowenstein-Jensen culture method and the absolute concentration method as the comparison,the fluorescent PCR melting curve method was used to detect the resistance to rifampin and isoniazid in 53 cases of pulmonary tuberculosis(TB)respectively.Results The single drug resistance rates and multidrug resistance (MDR) rate detected by the two methods had no significant statistical difference(P >0.05).The comparison between the two methods for detecting the same sample showed that compared with the absolute concentration method,the sensitivity and specificity of the melt-ing curve method for detecting rifampin-resistance,isoniazid-resistance were 80.0% and 81.0%,100.0% and 93.8% respectively, the accuracies were 92.2% and 86.8% respectively,the Kappa values in the consistency analysis of the two methods were 0.754 and 0.710 respectively,indicating the good consistency between them.Conclusion Compared with the traditional methods,the melting curve method has good sensitivity and good specificity with safety,high efficiency and good application value in the treat-ment of drug-resistant pulmonary TB.

Objective:To establish a fibrin zymography method for identifying the active proteins in lumbrokinase,and investigate the production difference and batch consistency of 5 different manufacturers. Methods:Fibrin zymography was used with the final con-centration of fibrinogen of 5 × 10 - 4 g·ml - 1 ,renature time of 30 min in 2. 5% Triton-x-100,incubation time of 30 min in PBS buffer (pH = 7. 4)at 37℃ and the protein concentration in the sample of 5. 0-37. 5 μg. Results:The sensitivity of the method was high,and the molecular weight distribution of active protein bands for the samples from five manufacturers was between 15KD and 40KD with 6 common active protein bands. The zymography of the samples from the five manufacturers had slight difference,while various batches of the samples from the same manufacturer showed no difference. Conclusion:The method is special. It can reflect molecular weight distribution and species of active protein,batch consistency and production process stability. It is easy to be standardized and suitable for the identification of lumbrokinase,which can lay foundation for the quality consistency evaluation of marketed products.

Objective To evaluate the relationship between vascular endothelial growth factor (VEGF) and extracellular signal-regulated kinase (ERK) signaling pathway in spinal dorsal horns of rats with neuropathic pain.Methods Twenty male Sprague-Dawley rats,aged 2 months,weighing 160-320 g,were randomly divided into 4 groups (n =5 each):sham operation group (group S); chronic constrictive injury (CCI) group; normal saline group (NS group); VEGF antibody group.Neuropathic pain was induced by CCI.The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The left sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1 mm intervals.In group S,the left sciatic nerve was only exposed but not ligated.In VEGF antibody group,VEGF antibody 0.3μg/15 μl was injected intrathecally every 2 days for 4 times starting from 2 h after CCI,while the equal volume of normal saline was injected in NS group.Paw withdrawal threshold to von Frey filament stimulation (PWMT) and paw withdrawal latency to nociceptive thermal stimulation (PWTL) were measured at 1 day before CCI (T1),and 1,3,5 and 7 days after CCI (T2-5).The rats were sacrificed after PWMT and PWTL were measured and the L4-6 segments of the spinal cord were removed for determination of phosphorylated ERK (p-ERK) expression in spinal dorsal horns by immunohistochemistry and Western blot.Results Compared with group S,PWMT and PWTL were significantly decreased at T2-5,and the p-ERK expression in spinal dorsal horns was up-regulated in CCI and VEGF antibody groups (P ＜ 0.05).Compared with CCI group,PWMT and PWTL were significantly increased at T3-5,and the p-ERK expression in spinal dorsal horns was down-regualted in VEGF antibody group (P ＜ 0.05).Conclusion VEGF in the spinal dorsal horn is involved in the development and maintenance of neuropathic pain in rats through activating ERK signaling pathway.

Nonalcoholic fatty liver disease (NAFLD) is a disease caused by multiple factors and can progress to liver cirrhosis and hepatocellular carcinoma. At present, the pathogenesis of NAFLD remains unclear and there are still no effective therapeutic drugs in clinical practice; therefore, it is particularly important to search for new therapeutic drugs that have few side effects and can effectively delay or reverse disease progression. Some studies have shown that related hormones produced by gastric tissue have a variety of effects in the regulation of energy homeostasis and obesity, and the expression level of inflammation-related genes in gastric fundus is consistent with the severity of liver disease; thus we have reason to believe that the stomach is one of the important participants in NAFLD. This article summarizes the role of ghrelin and obestatin produced by the stomach in the progression of NAFLD, which provides a new idea for the pathogenesis of NAFLD and a new direction for treatment.

Objective To investigate the clinical manifestations in patients with 22q11.2 deletion syndrome (22q11.2DS) to improve the understanding of the disease.Methods Twenty patients with 22q11.2 DS were enrolled from Children's Hospital of Fudan University between August 2008 and April 2014.Cytogenetic and molecular genetic methods included fluorescence in situ hybridization (10 cases),and multiplex ligation-dependent probe amplification (10 cases).Age at the time of the diagnosis,sex and clinical manifestations were analyzed.Results The subject group consisted of 20 patients.Among them,13 cases (65％) were male and 7 cases (35％) were female.The median diagnostic age was 3.9 months.The presence of congenital heart diseases was identified in 17 patients (85％) and surgical correction was performed in 9 cases of them.The most frequent of complex congenital heart diseases were tetralogy of Fallot (20％) and pulmonary atresia (20％).Ten patients had varying degrees of T-cell immune function defects.Decrease in total lymphocytes and only CD8 counts were present in 45％ and 5％,respectively.Hypogammaglobulinemia was not detected in any patient.Six eases with T-cell immune function defects were treated with thymosin,4 of which were followed up for months,and the prognosis was good.Hypocalcemia was detected in 6 patients (30％),3 of whom presented with hypocalcemic seizures and hypoparathyroidism.Craniofacial dysmorphisms were detected in 3 patients(15％),2 of them only presented with micrognathia.Otorhinolaryngologic abnormalities were found in 4 cases (20％),3 of whom had laryngeal abnormalities,one of whom had cleft palate.Psychomotor developmental delay was found in 9 cases.Conclusions Congenital heart defects,hypocalcemia and/or impaired immune function are diagnostic features for 22q1 1.2 deletion syndrome,and they should be considered for cytogenetic analysis.

Objective To explore the clinical significance of serum Toll-like receptor 4 (TLR4)/Myeloid differentiation factor 88 (MyD88) and D-dimer level detection in children with serious Mycoplasma pneumoniae pneumonia(MPP).Methods Ninety cases of MPP hospitalized children from June 2015 to December 2016 at Affiliated Hospital of Xuzhou Medical College were divided into serious MPP group (42 cases) and mild MPP group (48 cases)according to the severity of their illness.The level of serum D-dimer was detected by immune turbidimetry,and the expressions of TLR4,MyD88 and nuclear factor-κB (NF-κB) were detected by Western blot.Results (1) The level of D-dimer [(1 850.12 ± 153.50) μg/L vs.(297.36 ±27.42) μg/L],white blood counts (WBC) [(11.52 ± 0.38) × 109/L vs.(7.98 ± 0.62) × 109/L],neutrophile granuloeyte ratio (N) (0.87 ± 0.01 vs.0.55 ± 0.01),C-reactive protein (CRP) [(64.59 ± 7.93) mg/L vs.(19.79 ± 6.38) mg/L],as well as erythrocyte sedimentation rate (ESR) [(52.13 ± 1.8) mm/1 h vs.(22.78 ± 1.43) mm/1 h] in the serious MPP group were higher than those in the mild MPP group,and the differences were statistically significant (t =6.511,3.342,2.891,8.075,7.922,all P ＜ 0.05).(2)The expression of TLR4 (1.53 ±0.12 vs.0.45 ± 0.07),MyD88 (1.28 ±0.10 vs.0.37 ±0.12) and NF-κB (1.49 ± 0.16 vs.0.53 ±0.10) in the serious MPP group were higher than those in the mild MPP group,and the differences were statistically significant (t =3.511,7.614,8.122,all P ＜0.05).(3) The D-dimer levels,TLR4,MyD88 and NF-κB of the cases who had the image feature of lung patchy shadow (46 cases),atelectasis (17 cases) and pleural effusion (29 cases),were obviously higher than those who had not,and the differences were statistically significant(all P ＜ 0.05).(4) The plasma D-dimer level [(2 984.19 ± 138.43) μg/L vs.(640.48 ± 78.89) μg/L]and expressions of TLR4(2.53 ± 0.41 vs.0.92 ± 0.17),MyD88 (2.18 ± 0.12 vs.0.57 ± 0.06),NF-κB (2.47 ± 0.16 vs.0.89 ± 0.15) in the cases with extrapulmonary complications (13 cases) were higher than those without extrapulmonary complications,and the differences were statistically significant (all P ＜ 0.01).Conclusion The expression of TLR4/MyD88 increased in consistent with the up-regulation of D-dimer level in children with serious MPP,which indicated that the TLR4/MyD88 signaling pathway may participate in the formation of hypercoagulable state of children with serious MPP.

OBJECTIVE: To detect pathogenic variant of the FGD1 gene in a boy with Aarskog-Scott syndrome. METHODS: Genetic variant was detected by high-throughput sequencing. Suspected variant was verified by Sanger sequencing. The nature and impact of the candidate variant were predicted by bioinformatic analysis. RESULTS: The child was found to harbor a novel c.1906C>T hemizygous variant of the FGD1 gene, which has led to conversion of Arginine to Tryptophane at codon 636(p.Arg636Trp). The same variant was found in his mother but not father. Based on the American College of Medical Genetics and Genomics guidelines, the c.1906C>T variant of FGD1 gene was predicted to be likely pathogenic(PM1+PM2+PM5+PP2+PP3+PP4). CONCLUSION The novel c.1906C>T variant of the FGD1 gene may underlay the Aarskog-Scott syndrome in this child. Above finding has enabled diagnosis for the boy.
Child ; Dwarfism ; Face/abnormalities* ; Genetic Diseases, X-Linked ; Genitalia, Male/abnormalities* ; Guanine Nucleotide Exchange Factors/genetics* ; Hand Deformities, Congenital/genetics* ; Heart Defects, Congenital ; Humans ; Male ; Mutation