Objective To investigate the differences of clinical features,pulmonary function tests,chest imaging and prognosis between patients with idiopathic pulmonary fibrosis (IPF) combined with emphysema and without emphysema.Methods A total of 43 patients with IPF and with pulmonary fibrosis and emphysema (CPFE) were selected as observation group,and 40 patients with IPF and without emphysema were selected as control group.The clinical data of two groups of patients,including pulmonary function,partial pressure of oxygen,cellular components of bronchoalveolar lavage fluid (BALF),survival time were retrospectively analyzed and compared between two groups.Results The smoking index was (29 ± 17) pack years in observation group,much higher than that in control group (17 ± 15) pack years,the difference was statistically significant (P ＜ 0.05).The percentage of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was (70 ± 6)％ in observation group,significantly lower than that in control group (84 ± 9)％,the difference was statistically significant (P ＜ 0.05).The percentage of diffusion capacity of carbon monoxide (DLCO) in observation group was (43 ± 11)％,significantly lower than that in control group (55 ± 17)％,the difference was statistically significant (P ＜ 0.05).The percentage of lung volume in observation group was (78 ± 12)％,significantly higher than that in control group (63 ± 11)％,the difference was statistically significant (P ＜0.05).The vital capacity was expected to account for partial pressure had no significant difference in percentage and resting arterial oxygen value between two groups (P ＞ 0.05).The total number of BALF cells,macrophages,neutrophils,lymphoeytes and eosinophils ratio had no significant difference between two groups (P ＞ 0.05).Conclusion Smoking is an important risk factor of IPF with emphysema,emphysema does not affect the prognosis of patients with IPF.

Objective To investigate the characteristics of cognitive development in different aged neonates.Methods Sixty-two newborns were randomly selected from relatively normal full-term babies in Changzhou Children's Hospital from December 2013 to September 2015.Electroencephalogram (EEG) and event-related potentials (ERP) were recorded with the auditory Oddball paradigm.Cognitive EEG delta power and the N2 wave area of different ages (1-10,11-20 and 21-28 days) were compared.Paired t test,analysis of variance and the LSD test were used for statistical analysis.Results (1) Delta power in the resting and cognition state:neonatal cognitive delta power in the 11-20 and 21-28 days old groups was (268.22± 132.09) and (236.01±97.40) μ V2,respectively,significantly higher than the resting delta power of the same groups [(175.80 ± 80.80) and (178.78 ± 104.74) μ V2,t=2.539 and 2.845,P=0.020 and 0.010,respectively].(2) Cognitive delta power in different aged neonates:cognitive delta power in the 11-20 and 21-28 days old groups was (268.22± 132.09) and (236.01 ±97.40) μ V2,respectively,higher than that of the 1-10 days old group [(116.70± 56.70) μV2],with statistically significant difference (LSD test,both P＜0.05).(3) Neonatal ERP:ERP of the 1-10 days old group presented with multiple peaks of a flat composite wave,in the 11-20 and 21-28 days old groups,the N2 wave showed a regular and rising trend,gradually to a single wave,and became gradually mature.The N2 wave area in the 11-20 and 21-28 days old groups was (6 435.08±2 212.34) and (6 536.75± 1 969.86) ms · μ V,respectively,which was larger than that in the 1-10 days old group [(4 230.04± 1 550.55) ms · μ V] (LSD test,both P＜0.05).Conclusions Neonatal cognitive development is enhanced with age and there may be a period of more rapid cognitive development,especially at 11-20 days of age.

Objective To study the characteristics of cognitive development of newborns with auditory event related potentials (aERP).Methods Thirty full-term neonates who were admitted to Changzhou Children's Hospital and met the inclusion criteria, those with neonatal neural behavioral score over 37 and both ears passed the hearing screening, and exclusion criteria, those who suffered from perinatal brain injury, were sclccted randomly.Thcy wcre divided into three groups according to the days of age (group 1 : 1-10 days;group 2:11-20 days;group 3:21-28 days).aERP was recorded with auditory Oddball paradigm.The data were collected and analyzed by Brain Electrical Source Analysis software.Relationship between N2latencies/areas among the three groups and their age was researched with Pearson correlation analysis.Results During the neonatal period, there was a significant negative correlation between N2 latency and neonatal age in days (r=-0.609, P ＜ 0.05), while significant positive correlation was shown between N2 area and the age (r=0.689, P ＜ 0.05).In Fz and Cz leads, the total average waveform diagram of the three groups showed spacious flat, less smoothed curve, and mostly jagged pattern.N2 area in group 1 showed a complex plurality of peaks, and regular, soaring waves, which changed into single wave thereafter, in group 2 and 3.The N2 latencies tended to shorten gradually.Conclusions Neonatal cognitive competence, including concentration and discrimination ability, would be improved with their growth.

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Newborn brain damage is the main cause of new-borns' death and disabilities.Current research difficulties lie in analyzing characteristics of cerebral injuries,making objective prognosis and early intervention,as well as analysis of therapeutic effects after recovery.Since subjects are not requested to complete complex tasks while doing resting state functional MRI (rs-fMRI) tests,rs-fMRI is reckoned to be suitable for neonatal brain function research.So far,most rs-fMRI reports regarding cerebral injury are for adults,with only a few have been done on neonates.Foreign research are mainly focused on new borns' brain development.If relevant rs-fMRI research can be done on newborn brain damage,it would be helpful to accurately evaluate structure and function of patients' brain tissue damage.Further research can provide more valuable information in clinics.

Objective To investigate the characteristics of cognitive development of newborn's cerebral hemispheres with event related potential (ERP). Methods Forty-five healthy full-term newborns and 11 infants of 29-60 days in the Department of Newborns, Changzhou Children's Hospital between December 2013 and October 2015 were randomly included in this study. They fulfilled all inclusion/exclusion criteria. An auditory oddball paradigm was used with frequently occurring standand tones at 1 000 Hz with 90% probability and infrequent deviant tones at 2 000 Hz with 10% probability. Waveforms were recorded at Fz, Cz, F3, F4, C3 and C4 scalp locations. And a comparative study of area and latency of N2 was done at F3, F4, C3 and C4 scalp locations in the two hemispheres. Results N2 wave of 1-28 days neonatal at C3, C4 scalp locations: area (ms·μV) was 5 193.68±2 137.45 vs 4 324.51±1 334.73, with statistically significant difference (t=2.288, P=0.025);latency (ms) was 764.27±216.60 vs 878.29±294.06, also with statistically significant difference (t=2.185, P=0.031). N2 wave of 1-28 days neonatal at F3,F4 scalp locations: area (ms·μV) was 5 739.44±2 271.03 vs 5 614.87±2 280.83, without statistically significant difference;latency (ms) was 876.20±316.02 vs 860.45±289.04, also without statistically significant difference. N2 wave of 29-60 days infants at F3, F4 scalp locations: area (ms·μV) was 7 681.35±1 723.49 vs 5 993.55±735.63, with statistically significant difference (t=2.848, P=0.011);latency (ms) was 571.60±1.2248 vs 733.40±232.73, without statistically significant difference though F3 was shorter than F4. Conclusions The newborn's auditory perception cognition in the left side of central lobe is superior to the right side. With the growth of the newborn, the left side of the frontal lobe is also superior to that of the right side. Dominant hemisphere has appeared in the neonatal period. Proper stimulation can promote the newborn's cognitive development.

Objective: To investigate the physical and intellectual development and mutation characteristics of the phenylalanine hydroxylase (PAH) gene among 53 newborns with phenylketonuria (PKU), so as to provide insights into the management and genetic counseling of PKU Methods: The medical records of 54 children with definitive diagnosis of PKU and standardized therapy until 2 years at the Center for Neonatal Disease Screening of Shanxi Children' s Hospital from 2018 to 2021 were collected. Newborns' body weight and height developments were evaluated using the World Health Organization growth chart (2006 version), and the intellectual development was assessed using the national criteria of Development Behavior Assessment Scale among Children at Ages of 0 to 6 Years (WS/T 580-2017). The gene mutations were detected among neonates and their children, and the physical, intellectual developments and genetic characteristics of neonates with PKU were descriptively analyzed. Results: The 53 PKU cases included 29 male children and 24 female children, 36 cases with classic PKU and 17 cases with mild PKU, and 30 cases from rural areas and 23 cases from urban areas. The study subjects had a median age of 30 (10) d at initial therapy, and a mean blood phenylalanine concentration of (1 507±685) μmol/L at definitive diagnosis. There were 52 cases with normal height developments (98.11%), and all cases had normal weight and intellectual developments. The mean developmental functional quotient (DFQ) was significantly greater among urban children with PKU than among rural children [(94.92±8.57) vs. (87.65±6.57); t=-3.498, P=0.001], and the mean DFQ was significantly higher among children with mild PKU than among those with classic PKU [(95.55±8.76) vs. (88.57±7.11); t=-3.095, P=0.003]. There were 37 mutations detected in the PAH gene, which were mainly distributed in exons 3, 6, 7, 11, 12 and intron 4. Three high-frequency mutation sites were detected, including c.728G>A, c.611A>G and c.1197A>T, including three novel mutations (c.674C>G, c.1316-2A>C and c.1069T>C). Conclusions Following standardized treatment, the children with PKU have comparable physical and intellectual developments as compared to normal children. c.728G>A, c.611A>G and c.1197A>T were predominant mutations in the PAH gene among these 53 children with PKU, and three novel mutations were identified, including c.674C>G, c.1316-2A>C and c.1069T>C.

Objective To study the effect of interleukin (IL)-10 knockout (IL-10-/-) on renal repair after renal ischemia-reperfusion injury in mice.Methods Eighteen IL-10-/-mice (KO) aged 8-10 weeks and 18 C57BL/6 wild type mice (WT) aged 8-10 weeks were divided into control group (Sham) and renal ischemia-reperfusion injury (IRI) group.The renal tissue morphology change was observed by Hematoxylin and eosin (HE) staining and Masson staining.The expressions of IL-18, Ki67 and TGF-β1 were detected by immunohistochemistry.The expression of TGF-beta1 and IL-18 were detected by Western blotting.Results Compared with that in WT-IRI group, in KO-IRI group renal pathological damage was more severe, renal interstitial fibrosis was visible, Ki67 expression of renal tubular epithelial cells decreased distinctly (P＜0.01), the expression of TGF-betal increased significantly (P＜0.01).Conclusion Repair slows down significantly after kidney ischemia-reperfusion injury and fibrosis occurs gradually in IL-10-/-mice, eventually progressing to chronic kidney disease.

Objective To investigate the clinical significance of measuring resting energy expenditure (REE) for guiding an accurate nutritional support in elderly bedridden patients with nasal feeding.Methods The REE of 32 elderly bedridden patients with nasal feeding was assessed by using the Cosmed K4b2 portable telemetric gas analysis system.The waist-hip ratio, serum levels of albumin, transferrin, prealbumin and retinol-binding protein were determined to assess comprehensive nutrition status.The energy intakes were calculated, and the correlation of REE and the difference between the energy intakes and consumption with nutritional index were analyzed.Results The resting energy expendture was lower in the patients with waist-hip ratio≥0.95 than in patients with waist-hip ratio ＜0.95 (t=3.622, P＜0.01).The waist-hip ratio was reduced and serum albumin and transferrin levels were decreased along with the increase of REE in elderly patients (r=-0.55,-0.36 and-0.593, respectively, P=0.001, 0.043, ＜0.001).The difference between the energy intake and expenditure was higher in patients with waist-hip ratio≥0.95 than those with waist-hip ratio＜0.95 (t =5.643, P＜ 0.001).Serum albumin, prealbumin, transferrin and retinol-binding protein levels were increased along with the increase of the difference between the energy intake and expenditure, which showed the positive correlations (r=0.525, 0.409, 0.624, 0.414, respectively,P=0.002, 0.02, ＜0.001, 0.019).Conclusions Precise determination of REE and energy intake guided by REE are the important guarantees for the reasonable nutrition support in the elderly.

Objective To discuss the value of magnetic resonance (MR) diffusion tensor imaging (DTI) technology in the diagnosis of the apparent diffusion coefficient (ADC) and the fraction anisotropy (FA) of neonates with hypoxic-ischemic encephalopathy (HIE) in the subacute stage.Methods Ten cases of normal full-term neonates and 34 term neonates diagnosed with HIE in the subacute stage were investigated with conventional MR and DTI.Of the 34 cases, 15 cases were mild HIE, 12 cases were moderate HIE,7 cases were severe HIE.ADC/FA values in different parts of the brain were analyzed.And the receiver operating characteristic (ROC) curve was used,the sensitivity and specificity of the FA in specific parts were also analyzed.Results (1) On convention MRI : according to the MRl scoring system,score of mild group was(2.6 ±-1.7) points, moderate group was (3.0 ± 1.5) points, severe group was (5.8 ± 1.3) points.There was significant difference between mild group and severe group, moderate and severe group (P ＜ 0.05).(2) The ADC and FA values in each group on DTI : ADC values in all of the regions of interest (ROIs) had no statistic difference between the HIE group and the controls(all P ＞ 0.05).FA values in posterior limb of internal capsule (PLIC) ,splenium had statistic difference between the HIE group and the controls.FA values in mild group were (0.317-0.018,0.339 ±0.025) ,moderate group (0.295 ±0.025,0.324 ±0.026) and severe group (0.252 ±0.039,0.253-0.036) and control group (0.455 ± 0.047,0.372 ± 0.032).(3) ROC analysis of the neonates diagnosed with HIE:the area under the ROC curve of FA values in PLIC, Splenium had statistic difference between mild group and moderate group (P ＜ 0.05).The area under the ROC curve in each group was 0.744 (P =0.032) ,0.658 (P =0.164).ROC curve was used to evaluate the diagnostic accuracy of FA values in PLIC between HIE group and control group,when FA value was lower than 0.337,0.803 was the largest area under the ROC curve, and there was significant difference between them(P ＜ 0.01).Conclusions FA values can reflect the brain white matter WM injury of HIE neonates quantitatively,and its diagnostic veracity is better than ADC value and conventional MR during the subacute phase of HIE.The diagnostic veracity of FA values in PLIC is higher than other parts.When the FA value is lower than 0.337, there is good sensitivity and specificity in diagnosis of HIE, so DTI technology can provide accurate and objective basis for clinical treatment with good sensitivity and specificity about the diagnosis of HIE in early stage.