Objecfive To investigate the role of serum Insulin-like growth factor(IGF)-1,insulinlike growth factor-binding potein(IGFBP)-3 in children with Henoch-Schonlein purpura(HSP).Methods The serum concentration of IGF-1,1GFBP-3 was measured by enzyme-linked immunosorbent assay(ELISA)method in 45 acute SHP patients,40 recoverv patients and 30 healthy controls.Results The serum levels of IGF-1 [(452±183)μg/L],IGFBP-3 [(13 897±3124)μg/L] and C-reactive protein(CRP)[(20±8)mg/L]in acute phase were significantly higher than those in healthy controls(P<0.0 1)and higher than those during recovery period.The serum level of IGF-1,IGFBP-3 for the HSP patients dropped back slowly and their levels during recovery period were the same as those in healthy controls(P>0.05).The serum levels of IGF-1[(621±253)μg/L] and IGFBP-3[(18 763±3173)μg/L] were higher in the renal damage group than in the non-renal damage group(P<0.01).and the same in patients with gastrointestinal symptoms group as in patients without gastrointestinal symptoms group(P>0.05).whereas the serum level of CRP was not significantly different(P>0.05).The serum levels of IGF-1,IGFBP-3 showed positive correlation with the level of CRP(r=0.624,0.672,P<0.01).Conclusion The IGF-1 and IGFBP-3 may play an important role in the pathological mechanism of HSP.The level of IGF-1 may be used as an indicator for HSP disease activity and progression.IGF-1 mav have a close relation with the damageof renaJ system in HSP.

AIM: To investigate the effects of imipenem-cilastatin sodium combined with immunoglobulin on serum PCT, hs-CRP and TNF-α in child with baby sepsis complicated with disseminated intravascular coagulation (DIC). METHODS: Ninty-two cases of patients with sepsis and DIC neonates admitted to our hospital from January 2013 to April 2019 were enrolled in this study. All the children were divided into observation group and control group according to random number table method, 46 cases in each group. The patients in the control group were treated with imipenem-cilastatin sodium, and the patients in the observation group were treated with imipenem-cilastatin sodium combined with immunoglobulin. The efficacy of the two groups, the time of DIC index returned to normal, bleeding stopped and ICU hospitalization time, coagulation parameters (FIB, PLT, D-D, TT), serum inflammatory factor levels and incidence of adverse reactions were compared. RESULTS: The total effective rate of treatment in the observation group was 93.48% (43/46), which was higher than that in the control group (78.26%, 36/46) (P<0.05). The DIC index of the observation group returned to normal time, bleeding stop time, ICU hospitalization time was shorter than those of the control group (P<0.05). After 5 days of treatment, the plasma levels of FIB, D-D and TT were decreased in the two groups, and the observation group was lower than those of the control group, the difference was statistically significant (P<0.05). After 5 days of treatment, the expressions of serum PCT, hs-CRP and TNF-α were decreased in the two groups, and the observation group was lower than the control group (P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups [2.17% (1/46) vs. 6.52% (3/46)] (P>0.05). CONCLUSION: Imipenem-cilastatin combined with immunoglobulin is effective in the treatment of baby sepsis complicated with DIC. It can alleviate or eliminate bleeding and other symptoms, shorten ICU hospitalization time, improve coagulation function, and reduce serum PCT and hs-CRP, TNF-α expression, and the body's inflammatory response, combined with fewer adverse reactions, which has a higher clinical value.

Objective: To investigate the effect of high dose gamma globulin combined with naloxone in the treatment of severe viral encephalitis in children, and its influence on nerve function and immune function. Methods: From March 2012 to May 2017, 103 children with viral encephalitis in the First People's Hospital of Wenling were randomly divided into observation group (53 cases) and control group (50 cases) according to the digital table.The control group was given routine treatment.The observation group was given naloxone combined with high dose gamma globulin on the basis of routine treatment.The therapeutic effect, clinical symptoms, serum neurological function and humoral immune function were compared between the two groups. Results: The total effective rate of the observation group was significantly higher than that of the control group (92.45% vs.78.00%)(χ²=4.319, P<0.05). The clinical symptoms, signs disappearance time and hospitalization time of the observation group were significantly shorter than those of the control group [(2.17±0.56)d vs.(3.12±0.79)d; (2.25±0.31)d vs.(3.87±0.93)d; (3.84±0.46)d vs.(5.31±0.69)d; (2.01±0.83)d vs.(3.86±1.21)d; (1.85±0.58)d vs.(2.79±0.77)d; (11.36±2.14)d vs.(13.05±1.85)d; (10.21±3.05)d vs.(13.85±3.72)d](t=7.072, 11.998, 12.789, 9.093, 7.024, 4.276, 5.444, all P<0.05). After treatment, the serum NSE, S-100β and NGF levels of the two groups were significantly decreased[(12.64±1.22)ng/L vs.(18.95±2.15)ng/L, (0.85±0.24)ng/L vs.(1.69±0.35)ng/L, (0.17±0.05)ng/mL vs.(0.98±0.12)ng/mL, (16.38±1.38)ng/L vs.(19.04±2.78)ng/L, (1.22±0.30)ng/L vs.(1.70±0.41)ng/L, (0.33±0.10)ng/mL vs.(0.96±0.14)ng/mL] (t=18.583, 14.010, 45.361, 6.239, 6.878, 25.58, all P<0.05), and the serum neurological function indicators of the observation group were significantly lower than those of the control group (t=14.592, 6.931, 10.358, all P<0.05). After treatment, the level of IgG in the two groups were significantly higher than those before treatment[(15.62±2.31)g/L vs.(9.12±1.74)g/L; (11.52±2.05)g/L vs.(8.97±1.56)g/L](t=16.363, 6.999, all P<0.05), and the IgG level in the observation group was significantly higher than that in the control group(P<0.05). There were no significant changes in the levels of IgM in the two groups before and after treatment (all P>0.05). Conclusion High-dose gamma globulin combined with naloxone can effectively improve the clinical efficacy of severe viral encephalitis in children, help to improve the clinical symptoms and signs of children, at the same time help to restore the nervous function of children and improve the humoral immune function, which is worthy of clinical application.