Objective To explore the influence of monosialoglycans ganglioside(GM1) on dynamic changes of plasma BDNF and NSE in the treatment of neonatal hypoxic-ischemic encephalopathy(HIE).Methods According to the digital table,82 children with HIE were randomly divided into study group and control group, 41 cases in each group.The study group was given GM1 treatment,the control group was given routine treatment.The BDNF and NSE levels after birth 1,7,14 d of the two groups were detected.Results The BDNF levels in the study group at 7,14 days were higher than those in the control group[(1 823.3±286.2)pg/mL vs (1 368.3±229.2)pg/mL,t=3.07,P<0.01;(958.3±89.3)pg/mL vs (863.2±88.6)pg/mL,t=2.03,P<0.05].The NSE levels of moderate and severe children in the study group at 7 days were lower than those in the control group[(9.55±3.32)ng/L vs (14.31±2.52)ng/L,(20.22±3.63)ng/L vs (32.05±5.73)ng/L,t=5.32,4.69,all P<0.05].The incidence rate of complication in the study group was 4.88%,which was lower than 19.51% in the control group,the difference was statistically significant(x2=4.10,P<0.05).Conclusion GM1 in the treatment of HIE can achieve significant effect,and the plasma BDNF and NSE levels increase and decrease rapidly.

Objective To investigate the clinical application of serum procalcitonin(PCT ) ,high sensitive C reactive protein(hs‐CRP)and interleukin‐6(IL‐6)in children with acute respiratory infections .Methods 136 cases of children with acute respiratory in‐fections were selected as observation group ,according to the results of the laboratory diagnosis ,which were divided into bacterial in‐fection group and viral infection group ,at the same time ,at the same period 83 cases of healthy children were selected as control group .Comparison of the level of PCT ,hs‐CRP and IL‐6 between groups .The level of PCT ,hs‐CRP and IL‐6 before and after treat‐ment was studied at the same time .The diagnostic value of PCT ,CRP ,IL‐6 was compared .Results The level of PCT ,hs‐CRP ,IL‐6 in bacterial infection group was significantly higher than the control group ,the difference was statistically significant(P<0 .05) . After treatment ,the level of PCT ,hs‐CRP ,IL‐6 was lower than that before treatment ,the difference was statistically significant (P<0 .05) .The sensitivity ,specificity ,the positive prediction rate ,negative prediction rate and Youden index of PCR was relatively higher compared with the other two index ,the difference was statistically significant(P<0 .05) .Joint detection of sensitivity had improved ,while the specific degree and Youden index was reduced .Conclusion The levels of PCT ,hs‐CRP ,IL‐6 in children with a‐cute respiratory infections have important clinical significance .PCT is better and more real as index for judgement for bacterial in‐fection .Joint detection and comprehensive evaluation of three indicators could significantly improve the sensitivity of the acute re‐spiratory infections ,which is helpful for early diagnosis and prognosis evaluation .

Objective To observe the influence of different doses of intravenous immunoglobulin (IVIG) on function of T cells in cord blood of premature infants and to explore the immunomodulating mechanism of IVIG.Methods Cord blood mononuclear cells (CBMC) were isolated by density gradient centrifugation method from 15 preterm infants born between June 1,2011 to December 31,2011 at 32 34 gestational weeks.Three groups were formed according to the concentrations of IVIG used for CMBC culturing in vitro (Group A,6 mg/ml; Group B,9 mg/ml; Group C,12 mg/ml).After 72 hours in sterile conditions,the levels of IFN 7,IL 4,IL-10 and TGF β1 in the supernatant were determined by enzyme-linked immunosorbent assay.The expression of CD4+ CD25+ Foxp3+ Treg cells was examined by fluorescent activated cell sorter.Differences among groups were compared by one way analysis of variance.For comparison between two groups,LSD test was used.Results (1) The level of IFN γ secreted by CBMC in Group C was 0.03 ± 0.02,which was much lower than that in Group A(0.18±0.08) and Group B(0.13±0.05) (F=5.72,both P＜0.01).The level of IFN-γ in Group B and Group A did not show statistical difference (P＞0.05).Compared with Group A(0.03±0.01),the level of IL4 was much lower in Group B (0.02±0.01) and Group C(0.01±0.01) (F=20.38,both P＜0.01),while no significant difference was shown between Group B and Group C (P＞0.05).(2) No significant difference was found in the expression of CD4+CD25+Foxp3+Treg cells among different groups (F 0.67,P＞0.05).(3) The level of IL 10 in Group C was 3.02 ± 3.79,which was significantly lower than that in Group A (10.78±5.44) and Group B (6.90±4.64)(F=4.68,P＜0.01 and 0.05).The level of IL-10 inGroup B was still lower than that in Group A (P＜0.05).The levels of TGF-β1 in Group C(8.44± 13.71) and Group B(16.15 ±13.94) were significantly lower than that in Group A(30.23 ± 16.32) (F=5.22,P＜0.01,P＜0.05),but there was no significant difference between Group B and Group C (P＞0.05).Conclusions IVIG might inhibit the function of Th cells in CBMC of preterm infants in a dose dependent manner.IVIG could inhibit the function of natural Treg cells by regulating the secretion of cytokines IL-10 and TGF-β1 in a dose dependent effect.

Objective To investigate the risk factors of acute pancreatitis after endoscopic retrograde chloangiopancreatography (ERCP).Methods Clinical date of 1 041 patients who underwent therapeutic ERCP from January 2016 to August 2017 in department of gastroenterology,Zhongnan Hospital of Wuhan University,were retrospectively studied.Among them post-ERCP pancreatitis developed in 53 patients (PEP group) and the remaining 988 patients were assigned in the non-PEP group.The clinical characteristics,procedures of ERCP,gastrointestinal symptoms and laboratory findings after ERCP were compared between two groups.The SPSS software (version 22.0) was applied to analyze the risk factors of PEP.Results The overall incidence rate of PEP was 5.09％ (53/1 041).There were statistic difference in the number of white cells [8.56(5.43,12.23)× 109/L vs.7.12(5.58,9.20)× 109/L,Z=-2.122] and the ratio of neutrophils [0.82 ± 0.11 vs.0.76 ± 0.12,t=-3.612] after ERCP operation;the incidence of endoscopic sphincterotomy (EST) [60.37％(32/53) vs.43.72％(432/988),x2=5.646] and endoscopic papillary balloon dilation (EPBD)[50.94％(27/53) vs.33.00％(326/988),x2=7.230] during operation,and periampullary diverticula [35.85％(19/53) vs.52.98％(523/988),x2=4.619] (all P＜0.05).Logistic analysis indicated that the ratio of neutrophils was independent risk factor of PEP(OR=1.058,95％CI:1.019-1.098,P=0.003).Conclusion The number of white cells,the ratio of neutrophils after ERCP and endoscopic sphincterotomy,endoscopic papillary balloon dilation and periampullary diverticula are associated with PEP,while the ratio of neutrophils is the independent risk factor of PEP.