Objective To discuss the value and clinical significance of colonoscopy in children .Methods Colonoscopy was per-formed on 108 children with Olympus(PCF-Q260JI) .All polyps underwent electrocision .A retrospective study was performed in 108 children′s clinical and endoscopic examination data .Results 105 in 108 colonoscopy cases arrived at ileocesus successfully ,in which 98 cases were diseased .And the most common disease was colorectal polyps(65 cases) ,and 216 polyps were found .The 65 patients were performed resection in different ways ,and none bled and perforated;colorectal polyps were mainly single polyps .The lesions were often seen in proctosigmoid ,and mostly were juvenile polyps .Conclusion According to colonoscopy ,colorectal polyp is a important cause of disease .Colonoscopy is safe and reliable ,which can be very useful in diagnosis and treatment .

BACKGROUND: Although angiography is the gold standard for the diagnosis of cerebrovascular disease, it cannot be used widely because of its traumatotaxis. Transcranial Doppler ultrasound (TCD) and MRA are both non-invasive examinations, which can be used to evaluate intracranial large artery vascular trunks and hemodynamics.OBJECTIVE: To investigate the reliability of diagnosis with TCD on hemodynamic changes of ischemic cerebrovascular disease (ICVD) and the relativity between TCD and MRA.DESIGN: Case analysis based on patients.SETTING: Neurological Department of the First Affiliated Clinical Hos-pital, Harbin Medical University.PARTICIPANTS: From April 2001 to February 2002,totally 45 patients with stroke,selected from outpatients and inpatients of Neurological Department of First Affiliated Clinical Hospital of Harbin Medical University,examined by CT, to be told the fact and accepted, were taken part in the study.METHODS: Patients were examined with TC-2021 TCD instrument produced by German EME Corporation and VISART1.5T superconduct MR instrument produced by Toshiba. Totally 45 patients had TCD and MRI examinations, and the alternation between two examinations was 1 to 15 days. The hemodynamics and morphological changes were observed including middle cerebral artery (MCA), end of internal carotid artery (ICA),anterior cerebral artery (ACA), posterior cerebral artery (PCA), basal artery (BA), and vertebral artery (VA).large artery vascular trunks and hemodynamic results with TCD and MRA;ty, false positive and false negative with TCD with those of MRA.TCD and MRA: Theory data was Tmin=9.91; χ2=107.92, P ＜ 0.005, it was considered that the results with the rate of TCD were related with that of MRA. The detection rate of TCD was 19.06%, and that of MRA was 15.25%. There were significant differences between the detection rate of standard, the sensibility of diagnosing abnormal vessels by TCD was 78.10%, specificity 94.22%, false positive 7.46%, false negative 23.31%,and the coincidence rate 89.36%.CONCLUSION: TCD can assess exactly the functional status of the vessels. It can also reflect early and sensitively the change of hemodynamics of cerebral blood flow. While MRA can display the change of vascular appearance directly so that the combination of TCD and MRA will be improve sensibility and specificity of diagnosis.

Objective To investigate the expression levels of peripheral blood and clinical signifi-cance of High mobility group protein B1 (HMGB1) and toll-like receptor 4 (TLR-4) in children with systemic lupus erythematosus (SLE). Methods Enzyme-linked immuno sorbent assay (ELISA) was used to deter-mine the HMGB1 levels in the serum of peripheral venous blood samples from 33 SLE patients and 10 healthy children. RT-polymerase chain reaction (PCR) technique was used to detect the HMGB1-mRNA expression in the mononuclear cells of peripheral blood. Flow cytometry was adopted to detect the CD14/TLR-4 on the surface of mononuclear cell membrane in the peripheral blood of active SLE patients. One-way analysis of variance (ANOVA) was used to compare HMGB1 levels between the two groups. Pearson correlation and Logistic regression were used for correlation analysis. Results ① The levels of HMGB1 and HMGB1 mRNA in the peripheral blood of SLE active patients [(25.8 ±3.9) ng/ml and (0.80 ±0.16) respectively] were signifi-cantly higher than the stable group [(9.3 ±2.7) ng/ml and (0.46 ±0.18) respectively, F=7.0, 2.8, P<0.05] and healthy children [(9.1 ±0.9) ng/ml and (0.34 ±0.10) respectively, F=50.2, 7.5, P<0.05]. ② The CD14/TLR-4 expressions on the surface of mononuclear cell membrane in the peripheral blood of SLE active patients (91.2±1.3) were significantly higher than the stable group [(87.6±2.8), F=0.8, P<0.05] and the healthy children [(87.0±2.2), F=0.9, P<0.05].③There was significant positive correlation (r=0.48, P<0.05) between the levels of HMGB1 and CD14/TLR-4 in different SLE patients. In addition, the levels of HMGB1 were also positively correlated (r=0.48, P<0.01) with the detected concentrations of urinary protein in SLE patients. However, in the stable and healthy groups, there was no correlation between HMGB1 and CD14/TLR-4 and urinary protein. These indicate that HMGB1 outside the cell membrane were involved in SLE morbidity in children through TLR-4. Conclusion The mononuclear cells in peripheral blood of children with SLE can secrete HMGB1, which could lead to the increase of HMGB1 level in the serum of peripheral blood, and possibly participate in kidney damage of SLE through CD14/TLR-4.