Objective To investigate the relationship among serum levels of suppressors of cytokine signaling-3(SOCS-3),insulin-like growth factor binding protein-1(IGFBP-1) and hyperglycemia in critically ill children. Methods The 64 critically ill children who suffered from sepsis,after surgical repair of congenital heart dis-ease by extracorporeal circulation, and after surgery of severe traumatic from January 2009 to January 2012 in Depart-ment of Pediatric Intensive Care Unit( PICU) of Guangzhou Women and Children′s Medical Center were selected as the research object. According to the blood glucose levels on admission, the 64 children were divided into the normal glu-cose group and the hyperglycemia group. The 15 cases of healthy children in the same period in Guangzhou Women and Children′s Medical Center were selected as the healthy control group. The levels of blood glucose,insulin,SOCS-3,IG-FBP-1 and insulin resistance index( HOMA-IR) were measured and compared among groups when they were on ad-mission. Results (1) The blood glucose of the hyperglycemia group was significantly higher than those in the normal glucose group and the healthy control group[(9. 83±2. 48) mmol/L vs (4. 82±0. 76) mmol/L,(4. 49±0. 81) mmol/L] (P<0. 05). (2) Both of the insulin and HOMA-IR in critically ill children with hyperglycemia were significantly higher than those in the other 2 groups[9. 68(5. 85,17. 35) mU/L vs 4. 08(2. 00,7. 41) mU/L,2. 83(2. 00,10. 10) mU/L;4. 30(2. 70,7. 66) vs 0. 87(0. 39,1. 94),0. 52(0. 38,2. 56)](P<0. 05). (3) The serum SOCS-3,IGFBP-1 levels among the hyperglycemia group,the normal glucose group and the healthy control group were not of significant difference (P>0. 05). (4) The blood glucose was positively correlated with the insulin and HOMA-IR(r=0. 455,0. 773,P<0. 05),but there was no significant correlation among the blood glucose,insulin,HOMA-IR,SOCS-3 and IGFBP-1(P>0. 05). Con-clusions In the critically ill children,hyperglycemia was related to the insulin resistance which can not be evaluated through changes in serum levels of SOCS-3 and IGFBP-1. In addition,it cannot be excluded that the critically ill chil-dren may have insulin resistance and pancreaticβ-cell dysfunction simultaneously.

Sepis s is the leading cause of death in critically ill children,but it lack biomarkers with a higher sesn itivity and specificity for sepsis diagnosis,severity assessment,and prognostication.Soluble uroki-nase plasminogen activator receptor( suPAR) ,as a nvo el receptor ts imual ted by inflammation,is involved in the plasminogen activating pathways,inflammation and migration,adhesino ,chemotaxis,signal transduction of v ra ious immuen cell.suPAR serum levels have been shown to significantly incer ase in various infectious dis-easse .This revei w provided a ed scriptive overview of the role of suPARd etection in sepsis judgmne t and prognostication,hoping to find a perfetc biomarker for timely evaluait ng of chidlr en with spe sis and screening for childrena dmitted to the intensive care uin t in order to improve outcome and reduce mortality.

Objective To observe the therapeutic efficacy and safety of acupuncture and epidural anesthesia during full-term labor. Method A total of 199 eligible subjects experiencing natural labor were randomized into four groups. The acupuncture group was intervened by acupuncture at acupoints; the epidural group was given epidural anesthesia;the combined analgesia group was given acupuncture at acupoints plus epidural anesthesia; the control group was not given any interventions for analgesia. The Visual Analogue Scale (VAS) was adopted to record and compare labor pain (cervix dilation 3 cm at 0 min, 30 min, and 60 min, and at full cervix dilation); meanwhile, the active period of the first stage of labor, cervix dilation speed, the second stage of labor, Caesarean section (C-section) rate, instrumental delivery rate, Apgar score, and post-labor bleeding amount (2 h) were also recorded. The contents of blood β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) were monitored during the first stage of labor. Result Compared with the control group, the VAS scores dropped in the other three groups, and the decreases were similar in the epidural group and combined analgesia group, while the decrease in the acupuncture group was the least significant. Regarding the labor-related indexes, the cervix dilation speed was higher in the acupuncture group than in the control group(P<0.05), while there was no significant difference between the acupuncture group and control group in comparing the duration of the second labor stage(P>0.05). There were no significant between-group differencesin comparing the post-labor bleeding amount and Apgar score of the new-born babies(P>0.05), but compared with the epidural group, there was no use of assisted delivery. The content of blood β-EP during the first stage of labor increased in the acupuncture group and combined analgesic group(P<0.05), but there were no significant changes in the epidural group and control group(P>0.05). Conclusion Acupuncture analgesia can reduce labor pain and shorten labor duration without affecting the second stage of labor and security-related indexes.

Objective To analyze the effect of circulatory failure on ventilation therapy of respiratory failure after resuscitation in neonates with severe asphyxia. Methods Three hundred and eighty-two neonates with mechanical ventilation following severe asphyxia were retrospectively analyzed. Two groups were divided according to the efficacy of mechanical ventilation: effective and noneffective. Results The non-effective rate was 24.1% at 1 hour after ventilation (19.4% in full term babies,34.5% in preterm babies). The degree of asphyxia in noneffective group was significantly more severe than the effective group. The incidence of persistent pulmonary hypertension of the newborns(PPHN),exsanguine shock,cardiogenic shock,DIC and cardiac failure was 84.3%、51.0%、80 4%、49.0% and 54.9% respectively in term babies,while the incidence of exsanguine shock,cardiogenic shock,DIC and cardiac failure was 65.9%、68.3%、75.0% and 58.5% respectively in preterms babies. All of them were significantly higher than the effective group. After treatment of the circulation problems,the blood gas turned to normal in 94.1% term babies and 92.7% of preterms. No difference was shown in the recovery rate in both groups. Conclusion The circulatory failure is a main cause of non-effective mechanical ventilation in asphyxia neonates. To correct the pathophysiologic changes of the circulation in time can effectively improve the prognosis.

Objective To investigate the characteristics of stem cells marked with bromode oxyuridine (Brdu) and telomerase reverse transcriptase (TERT) in lung tissue, as well as its effects on pulmonary development and injury-repair. Methods A model of hyperoxia in neonatal rats was established by exposed to 95% O2 for 7 days. Before executing rats, Brdu was injected peritoneally, then Brdu and TERT positive cells were detected by immunohistochemistry. Results (1)The positive staining cells of Brdu with large nuclear located in septa and submucose of series bronchia, scattering in epithelium of bronchia, and the number of positive cells were less. The positive staining cells of TERT located in the septa and alveolar walls of peripulmonary tissue and the number of which was less than that of Brdu. (2)The positive cells of SPC located in septa and alveolar walls. Staining with Brdu and TERT, small number of positive cells was observed. (3) In hyperoxia and normal oxygen group, integral of expression of Brdu, TRET and SPC had no differences. But integral of expression of Brdu in whatever hyperoxia (1. 61?0. 83) or normal oxygen group (1. 43?0. 85) were higher than TRET and SPC (P

Objective To study the effect of dexamethasone on KGF expression in lungs of neonatal rats after hyperoxic exposure. Methods A randomized controlled study was designed in 48 Sprague-Dawley neonatal rats of 3 days old and divided into hyperoxia group, hyperoxia + dexamethasone and control groups for 7days. Histologic examination of the lung tissues were studied and radical alveoli count (RAC) were determined after HE staining. KGF expression was detected by immunohistochemistry. Results (1)The lungs of the rats in the hyperoxia group showed thinner walls of alveoli, simple alveolar structure, fewer and larger alveoli, expanded and shrinked alveoli. While those rats in the dexamethasone group showed more severe changes and some destroyed septa and walls of alveoli which lead to structure turbulence of the pulmonary tissue. The RAC in the hyperoxia and dexamethasone group was siginificanly lower than that in the control group (9.50?1.05, 10.03?3.26 vs 13.00?1.79, P

Objective To observe the correlation between the C-myc expression and pathologic lesions of kidney to explore the role of C-myc re-expression in children's primary nephrotic syndrome(CPNS). Methods The C-myc expression of renal tissue in 30 cases of CPNS was detected using immunohistochemical method, and the correlation between C-myc expression and renal pathological lesions was analyzed. Results There were various degrees of C-myc positive staining in the renal tissue of all patients with CPNS, while no C-myc positive expression in the renal tissue of control group. C-myc expression was mainly located in podocytes and less in endothelial cells of glomeruli. There was high level of C-myc expression in nephric tubules, especially in proximate tubules. There was no C-myc expression in the Henle's loop,tubulous matrix and vessel areas. There was no obvious difference in C-myc expression level in the podocytes and proximate tubules among the different pathological types of CPNS. The level of focal segmental glomerulosclerosis(FSGS) in proximate tubules obviously reduced compared with mesangil proliferative glomerulonephritis(MsPGN) and minimal change disease(MCD)(P

Objective:To explore the value of lactic acid (Lac), procalcitonin (PCT), sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score in assessing the severity and predicting the prognosis in sepsis shock.Methods:A retrospectively study was conducted. Patients with septic shock hospitalized in the department of critical care medicine of the Affiliated Hospital of Jining Medical University from April 2015 to June 2019 were enrrolled. The patient's gender, age, body mass index (BMI), infection site, organ dysfunction status; Lac, PCT, C-reactive protein (CRP), heart rate and body temperature immediately after admission to the intensive care unit (ICU); APACHEⅡ and SOFA scores within 24 hours, and 28-day prognosis were collected. According to the 28-day prognosis, the patients with septic shock were divided into the survival group and the death group, and the differences in the indicators between the groups were compared. Multivariate Logistic regression analysis was used to screen the risk factors of 28-day death in patients with septic shock; receiver operating characteristic curve (ROC curve) was used to analyze the value of Lac, PCT, SOFA, APACHEⅡ, and age in predicting the 28-day prognosis of patients with septic shock.Results:A total of 303 septic shock patients were enrolled, of which 124 cases survived and 179 died on the 28th day, and the 28-day mortality was 59.08%. ① Compared with the survival group, patients in the death group were older (years old: 66.58±15.22 vs. 61.15±15.68), APACHEⅡ, SOFA, proportion of lung infections, Lac increased [APACHEⅡ score: 22.79±7.62 vs. 17.98±6.88, SOFA score: 9.42±3.51 vs. 5.65±1.59, proportion of lung infections: 53.63% (96/179) vs. 39.52% (49/124), Lac (mmol/L): 5.10±3.72 vs. 3.71±2.56], oxygenation index (PaO 2/FiO 2) and ICU body temperature decreased [PaO 2/FiO 2 (mmHg, 1 mmHg = 0.133 kPa): 198.94±80.15 vs. 220.68±72.06, ICU body temperature (℃): 37.47±1.08 vs. 37.80±1.14], and the differences were statistically significant (all P < 0.05).②Multivariate Logistic regression analysis results: after adjusted for potential confounding factors, APACHEⅡ, PCT, Lac, age and SOFA were independent risk factors for death in patients with septic shock [APACHEⅡ: odds ratio ( OR) =1.05, 95% confidence interval (95% CI) was 1.01-1.10, P = 0.039; PCT: OR = 0.99, 95% CI was 0.98-1.00, P =0.012; Lac: OR = 1.23, 95% CI was 1.08-1.40, P = 0.002; age: OR = 1.03, 95% CI was 1.01-1.05, P =0.009; SOFA score: OR =1.88, 95% CI was 1.59-2.22, P < 0.001]. ③ROC curve analysis showed that APACHEⅡ, Lac, age and SOFA could predict the prognosis of patients with septic shock [APACHEⅡ: the area under the ROC curve (AUC) = 0.682 4, 95% CI was 0.621 7-0.743 1, P = 0.000; when the best cut-off value was 18.500, its sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 72.63%, 54.84%, 69.89%, 58.12%, 1.608 1 and 0.499 2, respectively. Lac: AUC = 0.604 5, 95% CI was 0.540 8-0.668 2, P = 0.002; when the best cut-off value was 3.550 mmol/L, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 50.84%, 73.39%, 73.39%, 50.94%, 1.910 3 and 0.669 9, respectively. Age: AUC = 0.599 1, 95% CI was 0.535 4-0.662 7, P = 0.003; when the best cut-off value was 72.500 years old, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 42.46%, 75.00%, 71.03%, 47.45%, 1.698 3 and 0.767 2, respectively. SOFA: AUC =0.822 3, 95% CI was 0.776 7-0.867 9, P = 0.000; when the best cut-off value was 7.500, its sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 68.72%, 87.90%, 89.13%, 66.06%, 5.680 4, 0.355 9 respectively]. The combined prediction had a good sensitivity (72.63%) and specificity (84.86%), and AUC (0.876 5) was higher than that of a single variable, suggested that the multivariate combination was more accurate in predicting the short-term outcome of septic shock. Conclusion:Lac, PCT, SOFA score, APACHEⅡ score and age were independent risk factors for death in patients with septic shock, and the accuracy of Lac, SOFA score, APACHEⅡ score and age in predicting short-term prognosis of septic shock was better than that of single variable, and the diagnostic value was higher.

Objective To clone and express a membrane protein(Tetraspanin 2) gene of Schistosoma japonicum (SjTsp2). Methods A pair of primers was designed to amplify the SjTsp2 gene which was subcloned into prokaryotic plasmid pET28a(+). The recombinant plasmid was transformed into E. coli BL21(D3) and followed by expression of the protein induced by IPTG. The protein was purified by affinity chromatography and used to immunize BALB/c mice. Dilution of antibody against SjTsp2 was determined by ELISA. The protein was also identified by Western blotting. Results Big loop of SjTsp2-A, 228 bp, was amplified in vitro by PCR. Its deduced amino sequence shared 52% similarity with SmTsp2. The soluble recombinant SjTsp2-A was expressed in the experiment and high dilution antibody against the recombinant (1 ∶ 32 000 in maximum) was produced in immunized mice. SjTsp2-A reacted positively with sera of acute and chronic schistosomiasis patients but not with sera from healthy persons by Western blotting. Conclusion SjTsp2 has been expressed and shows certain antigenicity.

Thirty-six male adult rats were divided into 12 groups. The rats, except the control group, were partially (68％) hepatectomized and then killed at intervals between 12-120h after operation. Isolated hepatocytes were prepared and flow cytometry was used to study the proliferative cycle. Mitotic index and binuclear cell count have been performed in liver sections and smears of isolated hepatocytes separately. Tetraploid cells acounted for 76% of all hepatocytes in normal rats and they also constituted the main proliferative population in regenerating liver. During 12-20h after operation, some of the tetraploid cells that remained in G_2 phase entered into mitosis. At 24h after operation, peaks of S phase in tetraploid cells and of octoploid cells occurred. At 36h after operation, mitotic index reached a maxium value and thereafter the percentage of binuclear cells were reduced rapidly. At 48-72h after operation, second peak of DNA synthesis occurred, but showed wide individual variations in time and cell proportion.