Objective To detect neuroendocrinal factor,and explore whether neurohormonal activation exists in children with conge-nital heart disease(CHD).Methods Concentrations of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),angiotensionⅡ(AngⅡ),aldosterone(ALD),endothelin-1(ET-1),and norepinephrine(NE)were determined in 100 children with CHD and were assayed at 24 hours,1 month,3 months and 6 months after interventional therapy in 70 cases with CHD.Results Children with CHD heart disease had elevated levels of ANP(25.6?7.5) pmol/L,BNP(15.7?7.4) pmol/L,ET-1(1.12?0.31) pmol/L(all P=0.0001),(AngⅡ)(90.3?11.5) ng/L,NE(1.07?0.08) nmol/L and ALD(246.1?42.3) pmol/L(all P=0.001).There was a highly significant stepwise increase in ANP,BNP,ET-1,AngⅡ,ALD and NE according to New York Heart Association class,with even asymptomatic patients having evidence of significant neurohormonal activation.The neurohormonal function gradually returned to normal after interven-(tional) therapy.Conclusions Neurohormonal activation in children CHD bears the hallmarks of chronic heart failure,relating to symptom severity and ventricular dysfunction.

6.66 kPa),30 cases of light degree pulmonary artery hypertension group (3.99 kPa

Aged ; Anthracosis ; complications ; Catheterization ; Drainage ; methods ; Humans ; Male ; Middle Aged ; Pleural Effusion ; etiology ; therapy ; Pneumothorax ; etiology ; therapy ; Retrospective Studies

Female ; Humans ; Hypopharynx ; Infant, Newborn ; Pharyngeal Diseases ; pathology ; Polyps ; pathology

12 ml/s was used as Group A and Qmax ≤12 ml/s as Group B. Results One week after removal of urinary catheter, dysury appeared in five cases with Qmax for (9.45?2.62) ml/s, of which two cases were with posterior urethral stricture, two with benign prostatic hyperplasia and one with weak detrusor contraction. Three months after removal of urinary catheter, six cases led to secondary dysuresia due to posterior urethral stricture and had Qmax for (6.28?3.26) ml/s, with significant difference compared with urodynamic parameters of normal group (P

Objective To evaluate four tumor markers of insulin-like growth factor 1((IGF-1), CEA, cytokeratin fragment antigen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) for the diagnosis and prediction of treatment response in human lung cancer. Methods Serum samples were taken from three groups: 91 patients with lung cancer, 30 healthy adults and 15 patients with benign pulmonary diseases. Serum IGF-1 was assayed by radioimmunoassay and CEA, CYFRA21-1, and NSE by electrochemiluminescence immunoassay. The differences among the three groups were determined by Kruskal-Wallis one-way analysis of variance (ANOVA) and with Mann-Whitney rank-sum test. Diagnostic efficacy was evaluated by ROC curves. Results The four serum tumor marker levels were significantly higher in lung cancer group, as compared with the benign and the healthy (IGF-1:χ2=26.95,P<0.001, CEA:χ2=49.11,P<0.001; CYFRA21-1:χ2=40.63,P<0.001; NSE:χ2=14.76;P<0.001). The diagnostic sensitivities of IGF-1, CEA, CYFRA21-1 and NSE was 75.6% (34/45), 53.3% (24/45), 66.7% (30/45) and 42.2% (19/45) respectively for lung cancer. The diagnostic sensitivity of IGF-1 combined with CYFRA21-1 was 95.5 %( 43/45) and that of IGF-1 combined with CEA and CYFRA21-1was 97.8%(44/45). Only IGF-1 and CYFRA21-1 showed significant changes before and after treatment (IGF-1: χ2=5.99,P=0.014; CYFRA21-1:χ2=4.99, P=0.025) in cancer group. Conclusions Serum IGF-1, CEA, CYFRA21-1 and NSE are all valuable for lung cancer diagnosis and the combination of those parameters can enhance the diagnostic efficiency. Serum IGF-1 and CYFRA21-1 may also be useful for evaluating the treatment response in lung cancer.

Clinical data and treatment of a patient with late-onset glutaric acidemia type Ⅱ who was admitted to the Department of Pediatric Intensive Care Unit (PICU) of Shenzhen Children′s Hospital were retrospectively analyzed.The patient is a female with the clinical manifestations of aggravated progressive proximal muscle weakness, accompanied by vomiting, abdominal pain and liver enlargement.A marked increase of transaminase, bilirubin and creatine kinase was detected, and hyperammonemia, hypoglycemia and metabolic acidosis were also observed in the patient.Blood amino acids and acylcarnitines spectra showed increased levels of various acylcarnitines.The muscle biopsy study suggested lipid storage myopathy (LSM), and the genetic test identified a homozygous mutation in the electron transfer flavoprotein dehydrogenase (ETFDH) gene.After treatment with Vitamin B 2, carnitine, coenzyme Q10 and plasma exchange, the motivate ability and biochemical parameters of the patient returned to normal.For patients with aggravated progressive proximal muscle weakness, hepatic dysfunction and increased serum creatine kinase levels, late-onset glutaric acidemia type Ⅱ should be considered.The key to early diagnosis and treatment of the disease is to improve the knowledge of it.

Objective To find a new indicator monitoring severe acute respiratory syndrome (SARS) by analyzing expression of lymphocytes and its subsets in SARS. Method Flow cytometer and hematology analyzer were used to detect the expression of lymphocytes and its subsets in 38 patients of SARS. Results Decreasing lymphocytes were found in 84 percent of the patients. The absolute value of lymphocyte subsets (T/B cell, NK cell) also decreased in a certain degree. Patients with decreasing T cell were mostly observed (95%). T helper/inducer (T 4)cells showed a higher rate of decreasing (100%) than T suppressor/killer (T 8)cells (87%). Based on the distribution of lymphocytes and its subsets, T cells demonstrated the greatest rate of decreasing (58%). Most patients had a relative normal B cells and NK cells with a rate of decreasing as little as 2.6% and 5.3%, respectively, more patients showed a decreasing T 4 cells (82%) than that of T 8 cells (34%). Forty-four percent of patients demonstrated a low ratio of T 4 to T 8. Conclusion The lymphocytes and its subsets were impaired in SARS, especially for T lymphocytes, T 4 cells were more seriously damaged than T 8 cells. The absolute counts of lymphocyte subsets showed more significant change of immune cells than relative counts of that in SARS.

BACKGROUND: Adhesion molecules are closely associated with inflammation. Inflammation due to white blood cell (WBC) infiltration and free radical injury following brain ischemia are believed to be important factors contributing to the pathogenesis of multi-infarct dementia.OBJECTIVE: To determine the level of serum adhesion molecules and free radicals in patients with multi-infarct dementia to explore the relationship between their levels and multi-infarct dementia.DESIGN: A case-control trial.SETTING: Department of Neurology, Second Affiliated Hospital of Jilin University.PARTICIPANTS: Totally 82 patients with multi-infarct dementia were hospitalized in the Department of Neurology, Second Affiliated Hospital of Jilin University between January 2000 and December 2004. These patients included 32 cases of mild dementia, 21 of moderate dementia, and 29 of severer dementia. The normal controls were 23 concomitant healthy volunteers who came for routine physical examination.METHODS: Enzyme-linked immunosorbent assay (ELISA) and electron spin resonance were used to determine the level of serum soluble intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM), as well as oxygen free radical concentration in the normal controls and patients with multi-infarct dementia, and the association between the severity of the illness and the levels of adhesion molecules and oxygen free radicals was analyzed.MAIN OUTCOME MEASURES: Serum levels of ICAM-1 and VCAM-1 and oxygen free radical concentration in the two groups.RESULTS: Totally 82 patients with multi-infarct dementia and 23 healthy controls were included in this study and all enter the result analysis. In multi-infarct dementia patients, the serum levels of soluble ICAM-1 and VCAM-1 and oxygen free radical concentration [(469.00±76.33), (196.00± 45.91) and (1 103.30±98.96) μg/L, respectively] were significantly higher than those of the control group [(601.00±76.30), (4.018±1.656), and (1.295±0.718) μg/g, respectively, t=5.517-6.754, P ＜ 0.01], and the 3 indices were positively correlated with the severity of dementia (r=0.659 4,r=0.697 2, r=0.649 4, respectively, P ＜ 0.05); serum ICAM-1 and VCAM-1 levels were positively correlated with the concentration of oxygen free radicals (r=0.714 7, r=0.732 4, respectively, P ＜ 0.01).CONCLUSION: Serum ICAM-1, VCAM-1 and oxygen free radicals might be implicated in the pathophysiological development of multi-infarct dementia, and their levels increase in parallel with the severity of dementia.

BACKGROUND: According to up-to-date development, the best timing to repair cleft palateis at 9-12 months old after birth when the articulation does not begin to develop.However, there are many over-eight-year-old children who still suffer from unrepaired cleft palate. Therefore, it is veryimportant to adopt proper surgery for these patients to improve palate form and articulatory function. OBJECTIVE: To study the characteristics of the cleft palate in patients of over 8 years old and the effects of palate repair and posterior pharyngeal flap transplantation (PPFT) on articulation. DESIGN:A controlled study with children patients as subjects. SETTING: Department of Maxillofacial Surgery, Medical College of Stomatology, Fourth Military Medical University of Chinese PLA PARTICIPANTS: Twenty-four children patients of cleft palate who were treated in the Department of Maxillofacial Surgery ,Medical College of Stomatology, Fourth Military Medical University of Chinese PLA from January 2000 through December 2003 were enrolled in the study. Fourteen were male and ten female. Their ages varied from 8 to 20 years old (mean 13.8 years). Three cases were bilateral complete cleft palate and twelve cases were unilateral complete cleft palate. Nine were incomplete cleft palate. METHODS :Two flap palatoplasty and upper pedicle PPFT were conducted in all the patients. In thirty days after surgical treatment, the patients were asked to repeat the words of a doctor in the phonetic lab with his or her lips 10 cm away from microphone. The words of the patients were recorded and evaluated subjectively by 5 doctors specialized in pathologic phones. MAIN OUTCOME MEASURES :The palatopharynx was observed with nasopharyngoscope before and after operation. And the improvement of nasal gas leakage and enhanced rhinophonia were also evaluated. RESULTS: The repaired cleft palate was healed in the first intention in all the patients. The soft palate retreated satisfactorily and the palatopharynx was apparently closed, which created good preconditions for articulation. The patients' articulation was also improved in different degrees. All the 24 patients had the fourth grade of enhanced rhinophonia and nasal gas leakage before repairing. After palate repair and PPFT, the enhanced rhinophonia and nasal gas leakage of grade 1 was in 3 patients, grade 2 in seven, grade 3 in six and grade 4 in eight patients. CONCLUSION: The combination of palate repair and pharyngoplasty is able to improve the form of soft palate and the articulation of over-eightyear-old patients with cleft palate.