Coma is one of the most serious type of consciousness disturbances.The causes of coma are complicated and the mortality rate is high.In this review,we discuss the definition,diagnosis and emergency treatment of coma,which is helpful for pediatricians to have a deeper understanding of coma,make correct diagnosis and administer appropriate treatment more quickly.

The ketogenic diet is a high-fat,low-carbohydrate diet that imitates ketone bodies from hunger produce,is a kind of treatment for children with refractory epilepsy.Autism is a subtype of pervasive developmental disorder characterized by impaired social interaction,language barriers and stereotyped behavior.Some children may be associated with epilepsy.Early rehabilitation education and training are the main method of treatment.This review summarized ketogenic diet clinical applications for the treatment of children with autism and potential mechanisms.

BACKGROUND:Constructing a three-dimensional tissue-like structure in vitro plays a critical role in modern tissue engineering and regenerative medicine. Several advances have been made in the past decade. However, it is stil a chal enge to promote microvascular-like structure formation and improve limited nutritional transportation, thereby promoting cel viability.
OBJECTIVE:To explore the feasibility of constructing a three-dimensional microvascular-like structure through the co-culture technique.
METHODS:Human bone marrow mesenchymal stem cel s and human endothelial cel s were co-cultured on a three-dimensional porous silk scaffold. Cel proliferation was analyzed by Pico-green DNA assay. Their growth profiles were evaluated by scanning electron microscope and laser scanning confocal microscopy, respectively. The mRNA levels of von Wil ebrand factor and CD31, two key functional markers of endothelial cel s, in the co-cultured endothelial cel s was assayed by real-time quantitative reverse transcription-PCR.
RESULTS AND CONCLUSION:The three-dimensional culture system constructed by the silk scaffold and bone marrow mesenchymal stem cel s provided an ideal microenvironment for cel growth and proliferation in vitro. Moreover, this microenvironment was capable of promoting endothelial cel differentiation evidenced by their significantly improved mRNA levels of von Wil ebrand factor and CD31. Premicrovascular-like structure was also observed in the co-cultures under the confocal microscope. Thus, al the data supported that the unique co-culture system could promote endothelial cel differentiation and self-assembling in vitro. This culture system provides a robust tool for the studies addressing microvessel-based tissue engineering.

Objective To discuss total vertebrectomy and spine stability and reconstruction by pos-terior ap proach for thoracic vertebra tumor and pedicle screw system fixation and intervertebral fusion.Methods Eighteen patients of 3males and15females of thoracic total vertebral tumor were operated in this group.The age of the group were from14to58years old,with the average of 23years.There were4aneurysmal bone cysts,2hemangiomas,2osteoblastomas,1neurilemomas,5giant cell tumor,1solitary myeloma and3metastatic thoracic vertebra tumors.The locations of the tumors was T 4 in1case,T 5 in1case,T 6 in2cases,T 8 in4cases,T 9 in3cases,T 10 in4cases,T 11 in2cases and T 12 in1case respectively.Pre-operative Frankel classification was grade A in6cases,B in7cases,C in3cases and E in2cases.Cir-cumferential decompression was performed with total spondylectomy through one-stage posterior ap proach.Anterior verte bral reconstruction was provided by autograft(ribs or ilium)bone or metallic cage;Posterior reconstruction was achieved by pedi cle screws system of CD or TSRH,Scofix fixation and auto graft fusion.Results The mean follow-up was8months,ranging from3months to24months.Twelve of 16cases with neu ro logical dysfunction were recovered completely,1case recovered from Frankel grade A to C,2cases from grade A to D,1case from grade B to D.The patient with neurilemmoma recurred and became ma lig nant after20months of operation and died4months later.One case of metastatic tumor of lung cancer sur vived6months after opera tion.One patient with giant cell tumor recurred.The other patients were still alive in the latest follow-up.There were no instruments breakage and spinal instability during the follow-up.Conclusion If the thoracic total vertebral tumor compress spinal cord se riously,the patients should be indi cat-ed for surgical treatment constructively.Total vertebrectomy followed by one-stage posterior approach re con-struction could relieve the com pression caused by tumor and reconstruct the stabilization of spine effectively.

Objective To study the utility of brainstem auditory evoked potentials in the evaluation of children with cerebral palsy. Methods In a group of 86 cases of cerebral palsy aged 6～30 months and a control group of 60 normal children, the brainstem auditory evoked potentials were recorded and subsequently analyzed and evaluated correlatively with asphyxia during birth and their functional impairments (including the visual, speech impairment, epilepsy and eating dysfunction). Results The latencies of waves Ⅲ?Ⅴ,the interpeak latencies(IPLs) of waves Ⅲ-Ⅴof BAEP in children with cerebral palsy were often abnormal( P

Objective:To establish a method for the determination of fenofibrate in fenofibrate capsules .Methods: HPLC was performed on a Dikma Diamonsil C18column (150 mm ×4.6 mm, 5 μm).The mobile phase was acetonitrile-water (7030, adjusting pH to 2.5 with phosphoric acid) and the detection wavelength was 286 nm.The flow rate was 1.0 ml· min-1 and the column tempera-ture was 30 ℃.The injection volume was 20 μl.Results:The linear range of fenofibrate was 10.07-60.42 μg· ml-1(r=0.9996) and the average recovery was 99.26%(RSD=0.5%,n=6).Conclusion:The method is simple, accurate and special, which can be used for the quality control of fenofibrate capsules .

Objective To establish the determination of luteolin and 1,7-dihydroxy-3,8-dimethoxyxanthone in Herbal Gentianopsis paludosa. Method The RP-HPLC with ZORBAX SB-C18 (250 mm?4.6 mm, 5 ?m) comlum was used. Mobile phase was methanol (A)-0.4% H3PO4 (B) Gradient elution was used, 0～15 min, A∶B=50∶50, 15～60 min, A∶B=55∶45. Detection wavelengh was 260 nm. Flow rate was 1.0 mL/min. Temperature of column was 30 ℃. Result The linear relationship of 1,7-dihydroxy-3,8-dimethoxyxanthone and luteolin were showed at the range of 0.084～0.84 ?g and 0.184～1.84 ?g (r=0.999 4 and r =0.999 7). The average recovery rate of 1,7-dihydroxy-3,8-dimethoxyxanthone and luteolin were 96.82% and 97.19%, RSD

Objective:To prepare Jieheling dispersible tablets and establish the dissolution determination method. Methods:The dissolution of fischeriana B in the tablets was determined by HPLC. The column was Kromasil C18(250 mm ×4.6 mm,5μm)with ace-tonitrile-water (40∶60) as the mobile phase at a flow rate of 1. 0 ml·min-1 . The detection wavelength was at 290nm. The column temperature was 30℃ and the sample size was 100 μl. Results: The linear range of fischeriana B was 0. 005-0. 057 μg ( r =0. 999 6). The average recovery was between 95% and 105%. Phosphate solution with pH of 6. 8 was used as the dissolution medi-um. Conclusion:The method is simple, accurate and specific, and can be used in the quality control of Jieheling dispersible tablets.

AIM:To study the protective effect of procyanidin single active ingredient B2 (PC-B2) on human endothelial progenitor cells ( EPCs) stimulated with high glucose.METHODS: The human EPCs were isolated from pe-ripheral blood of healthy people and identified.The EPCs were divided into control group (PBS treatment), hypertonic control group (25 mmol/L mannitol treatment), high glucose (30 mmol/L) group, and different concentrations (2, 10 and 50 mg/L) of PC-B2+30 mmol/L glucose groups.The viability of EPCs was detected by CCK-8 assay.The levels of LDH, MDA, SOD and GSH in the EPCs were detected.The changes of NO, ET-1, ICAM-1 and VCAM-1 in the EPCs cultured medium were measured by ELISA.The cell apoptotic rate and reactive oxygen species ( ROS) in the EPCs were analyzed by flow cytometry.The expression of VEGF and VEGFR-2 in the EPCs were determined by Western blot.RE-SULTS:Compared with control group, the viability of human EPCs was decreased significantly in 30 mmol/L glucose group (P<0.05).The LDH leakage, MDA content and the releases of ET-1, ICAM-1 and VCAM-1 were induced signifi-
cantly (P<0.05), but SOD and GSH activity and NO production were decreased significantly (P<0.05).The ROS and cell apoptotic rate were increased significantly (P<0.05).The expression of VEGF and VEGFR-2 in the EPCs were de-creased (P<0.05).When human EPCs were treated with different concentrations of PC-B2 and 30 mmol/L glucose, the viability was obviously rebounded (P<0.05), the LDH leakage, MDA content and the releases of ET-1, ICAM-1 and VCAM-1 were decreased gradually (P<0.05), the SOD, GSH activity and NO production were increased significantly (P<0.05), the ROS and cell apoptotic rate were decreased significantly (P<0.05), and the expression of VEGF and VEGFR-2 in the EPCs was increased gradually ( P <0.05 ) .CONCLUSION: PC-B2 enhances the viability of human EPCs under high glucose condition, reduces high glucose-induced oxidative damage, restores the EPCs normal function, and reduces the releases of inflammatory cytokines and apoptosis, thus playing a protective effect on human EPCs through inducing the expression of VEGF and VEGFR-2.

Objective To establish the quality standard of flavone extracts in licorice residue; To provide the methods and basis for the quality control of total flavonoids extracted from licorice residue.Methods TLC was applied to compare the extracts with liquiritin and licorice; UV-spectrophotometry was used to measure the content of total flavones; EDTA-2Na titration was used to determine the content of calciumion.Results In the chromatogram of the test product, the spots of the same color were displayed on the corresponding position of the control medicinal material, and the fluorescent spots of the same color were displayed on the corresponding position of the control product. UV-spectrophotometry showed glycyrrhizin had a good linear relationship in the range of 3.32–9.96 μg/mL (r=0.9997), the absorbance between 0.3 and 0.7. The average recovery rate was 102.41% (RSD=3.22%), and the average content of total flavonoids in three batches of flavonoids extract was 8.82%. The average content of calciumion was 0.107% (RSD=3.61%).Conclusion This method has good repeatability, high sensitivity and accurate results, and can be used for the quality control of flavonoids in licorice residue.