Objective:To explore the effects of brain ischemia on the immune system and the expression of Acetyl-cholinesterase(AChE) and Caspase-3 after neuro-immunological injury.Methods:The serum IL-4,IL-10,TNF-?,IL-2 and IL-12 concentrations and AChE level in brain,thymus and spleen of the rat brain ischemia at different time spots were detected by ELISA.The active fragments of Caspase-3 P17 and P32 in brain,thymus and spleen were tested by Western blot.The expression of AChE in nerve cells was examined immunohistochemistry.The relationship between amount of AChE and concentrations of the cytokines or NK activity as well as cell apoptosis was analyzed.Results:The concentration of AChE in brain increased gradually after ischemia,the level reached peak after 12 hours,and then decreased afterward.The AChE level in thymus and spleen increased after 1 h in accordance with the ischemic brain.The NK activity,serum TNF-?,IL-2 and IL-12 levels also increased at 0.5 h,1 h and 2 h after ischemia,but the trend reversed after 3 hours.Serum IL-4 and IL-10 levels did not change significantly at 0.5 h,1 h and 2 h after ischemia,but serum IL-10 raised after 3 hours to 48 hours.Serum IL-4 level slightly increased only appearing at ischemia 12 h point.The ratio of P17/(P17+P32) became higher with ischemic time.Conclusion:Sustained rising of AChE level due to brain ischemia induces the apoptosis of cells in the brain,thymus and spleen via activation caspase-3,leading to Th1/Th2 imbalance and immune dysfunctions.

Objective To explore the mutation in corel β3-galactosyl-transferase specific molecular chaperone(Cosmc、no-coding region and it's effects on the transcription level of Cosmc in Tn antigen positive tumor cells.Methods The Tn antigen positive(Tn+)and negative(Tn-)cells were separated from tumor tissues by immune magnetic bead,then the genomic DNA(gDNA),total RNA were prepared by Qiagen AllPrep DNA/RNA mini kit. In these cells.the transcription levels of T-synthase and Cosmc mRNA were tested by RT-PCR.the DNA of Cosmc non-coding region was amplified by PCR,the mutation in Cosmc non-coding region were further detected by sequencing.Results There are no mutation appearing in Tn-cells,one or more mosaic sequence allele appearing in portion of patient's Tn-cells.Almost of the Tn+cells which separated from tumor tissues and Jurkat T cell exists mutation.but the mutation style and mutation point were not saine in different tumor.Thtee patient's Tn+cells have loss of hetemzygosity(LOH),four patient's Tn+cells and Jurkat T cell have point mutation.Although no difference of transcription level of T-synthase mRNA in Tn+ and Tn-cells.but the transcription level of Cosmc mRNA in Tn+ cell was much lower than that in Tn-cell.The ratio of T-synthase/Cosmc mRNA in Tn+ tumor cells was hiigher than that in Tn-cell.Conclusion The tumor Tn antigen arise from mutation in Cosmc non-coding region maybe result from transcription level decreased of Cosmc mRNA.

Objective To study the current status of catheter - related thrombosis(CRT)in Chinese children through a retrospective analysis of the inpatients in the Department of Medicine,Beijing Children's Hospital Affiliated to Capital Medical University. Methods The clinical data of the inpatients with CRT from November 2010 to November 2013 were collected retrospectively,and the causes,clinical symptoms,diagnosis,treatment and prognosis were ana-lyzed. Results There were 42 cases of children with CRT in Beijing Children's Hospital Affiliated to Capital Medical University. Among the cases,the male to female ratio was 1. 0:0. 5;the median age of onset was 88(2 - 186)months with ﹤ 1 year old counted for 16. 7%(7 / 42 cases)and 13 - 14 years old counted for 11. 9%(5 / 42 cases);the distri-bution differences between the male and the female age were not significant(P = 0. 826). The median time from cathe-terization to CRT onset was 9(1 - 81)days,0 - 10 days after catheterization was the peak of onset(52. 5% ,21 / 40 ca-ses)followed by 10 - 20 days(35. 0% ,14 / 40 cases). The protopathy was usually hematologic tumor,kidney disease or deep fungal infection. Slightly more cases developed CRT on the right side(57. 1% ,24 / 42 cases)than on the left side (38. 1% ,18 / 42 cases). All cases were diagnosed by using B - ultrasound,of whom 28. 6%(12 / 42 cases)were symp-tom - free. After being diagnosed,7. 1%(3 / 42 cases)were treated with conservative methods such as immobilization of the affected limbs and hot compress;7. 1%(3 / 42 cases)had catheter removed;anticoagulant and/ or thrombolytics after catheter removal used in 33. 3% patients(14 / 42 cases). After 1 week,22 cases were reviewed,of whom 54. 5%(12 / 22 cases)had thrombosis reduced(all with intervention),thrombosis growing in 22. 7% patients(5 / 22 cases), and thrombosis did not change in 22. 7% patients(5 / 22 cases). Three cases needed re - catheterization after catheter removal,and all of 3 cases had CRT recurrences(100% ). Conclusions CRT is more common among infants and senior children. CRT usually develops within 20 days after catheterization. Children with hematologic tumor,kidney disease or deep fungal infection are more likely to have CRT. Routine ultrasound test should be conducted to monitor CRT in catheterized children. Once CRT is diagnosed,patients need to be treated with anticoagulants and/ or thrombo-lytics. Catheter should also be removed if necessary. Recatheterization can result in CRT recurrence.

Objective To investigate the effect of Buyang Huanwu Decoction on blood-brain barrier of focal cerebral ischemia rats, and explore the mechanism of the decoction. Methods The model of focal cerebral ischemia was made by thread embolism method. SD rats were divided randomly into sham-operated group, model group and Buyang Huanwu Decoction group. Buyang Huanwu Decoction group was given Buyang Huanwu Decoction by gavage, the sham-operated group and model group were given normal saline of the same quantity 24 h after modeling. The nervous function deficit scores was evaluated, brain tissues and serum were taken from the rats after treating for seven days, infarct volume was detected by TTC staining, and pathological changes of microvessel were observed microscopically in HE stained sections. And the protein level of MMP-9, MMP-2, VEGF in brain tissue and the serum levels of vWF in serum of every groups were measured by ELISA. Results Compared with model group, Buyang Huanwu Decoction significantly improved the neurological behavior performance, decreased the cerebral infarct volume, alleviated the pathological changes and decreased the protein level of MMP-9, MMP-2, VEGF, vWF. Conclusion Buyang Huanwu Decoction has the protective effect on blood-brain barrier in the model rats of focal cerebral ischemia. The mechanism may be related with restrainning the expression of MMP-9, MMP-2, VEGF, vWF.

Background and purpose:In recent years, energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus? (HF) and Ligasure Small Jaw? (LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the effcacy and safety of HF and LSJ in open thyroidectomy.Methods:The data from patients who undertook total thyroidectomy with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients, and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the ifrst postoperative day. The safety was appraised by comparing the incidence of postoperative complications.Results:The results of the effectiveness:the average duration of operation was (95.8±18.0) min for HF group, and (97.8±19.1) min for LSJ group, there was no statistical signiifcance (P=0.363). Postoperative volume of drainage on the ifrst postoperative day was (35.2±20.3) mL for HF group, and (36.3±23.8) mL for LSJ group, there was no statistical signiifcance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypo-parathyroidism was detected in 18 patients (18.0%) of HF group, and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the ifrst postoperative day was (12.3±12.8) pg/mL in HF group, and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group, and (0.20±0.16) mg/dL in LSJ group. There were all no statistical signiifcances (P>0.05).Conclusion:Both HF and LSJ are safe and effective in open thy-roidectomy without similar operative complications.

Objective:To find the possible mechanisms of endovascular radiation in the prevention of restenosis in rabbits following carotid endarterectomy and to observe the dose effect relationship.Methods:Twenty four rabbits were randomly divided into three groups following carotid endarterectomy (each n=8) and were allocated to receive a radiation dose of 0,10,20Gy( 32 P)respectively.Changes in the levels of plasma nitric oxide(NO) and endothelin 1(ET 1)were measured 3 day before operation and 3,7,14,28 day after operation.Results:The plasma NO was markedly increased and ET 1 was markedly decreased in endovascular radiation groups compared to control groups.The results were similar in the two groups(10Gy versus 20Gy).Conclusion:The endovascular radiation may inhibit smooth muscle cell proliferation and migration,and thus prevent restenosis by increasing NO and decreasing the level of ET 1.Changes of the levels of plasma NO and ET 1 is a practicable methods to detect the effect of therapy.

Objective To analyze the antibiotic resistance of the carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients and the resistant genes of carbapenemase-producing.Methods In all,46 carbapenem no-susceptibility Enterobacteriaceae strains were isolated from patients at Beijing Children's Hospital between January 2008 and December 2010.Agar dilution method recommended by the Clinical and Laboratory Standards Institute was used to examine the minimum inhibitory concentrations (MICs) of 14 antimicrobial agents.Phenotypic testing for carbapenemase-producing was conducted using Hodge test and double-disk synergy test.PCR was used to detect the expression of the carbapenemase-related genes KPC,GES,IMI/NMC-A,SME,IMP,VIM,GIM,SPM,SIM and OXA.WHONET5.6 was used to perform resistance analysis.Results Among 46 carbapenem no-susceptibility Enterobacteriaceae strains,26 (56.5％) were Klebsiella pneumoniae strains,13(28.3％ ) were Enterobacter cloacae and 7( 15.2％ ) were Escherichia coli.The rates of imipenem and meropenem no-susceptibility Klebsiella pneumoniae were 69.2％ and 80.8％,Enterobacter cloacae were 76.9％ and 100％ and Escherichia coli were 85.7％ and 100％,respectively.40(87.0％ ) strains were positive of Hodge test.41 (89.1％) strains were positive of doubledisk synergy test.38 (82.6％) were positive for the IMP genotype.The carbapenemase-related genes were not found in other 8 strains.Conclusion The prevalence of carbapenem no-susceptibility Enterobacteriaceae strains in Klebsiella pneumoniae isolates is relatively high in children.Resistance to imipenem was lower than that to meropenem from Klebsiella pneumoniae,Enterobacter cloacae and Escherichia coli strains.Many carbapenem no-susceptibility Enterobacteriaceae isolated from pediatric patients carry the blaIMP gene.No the KPC gene was found.

Objective To study the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and to investigate the mechanisms whether may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphoryla-tion .Methods Thirty SD rats(in either gender ,weighing 220-270 g) were randomly divided into five groups :Sham-operated group (Ⅰ) ,ischemia-reperfusion group(Ⅱ);sufentanil preconditioning group(5 μg/kg ,Ⅲ) ,SB203580(an inhibitor of p38 MAPK) group (Ⅳ) ,and dimethyl sulphoxide (DMSO) control group(Ⅴ) .Sample specimens were collected from each group at 240 minutes after reperfusion .Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured by an automatic biochem-ical analyzer .Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissue was measured .HE staining was used to ob-serve the hepatic pathological changes ,and to examine the expression of phosphor-p38 mitogen-activated protein kinases (p-p38 MAPK)of hepatic tissues by western blotting .Results Compared with group Ⅰ ,levels of AST ,ALT and MDA showed signifi-cantly increased in group Ⅱ-Ⅴ ,but levels of SOD decreased ,and obvious pathological changes were observed in the liver .In GroupⅢ significantly decreased the elevated levels of ASL ,ALT and MDA but increased levels of SOD ,and lessened hepatic pathological changes ,caused promoted p38 MAPK phosphorylation at 240 minutes after reperfusion .The protective effects of sufentanil precon-ditioning were abolished by SB203580 pretreatment .There were no significant differences between group Ⅴ and group Ⅱ .Conclu-sion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury .The protective mechanisms may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphorylation .

Objective To detect the difference of cerebral gray matter change in children with different karyotype Turner Syndrome (TS) by using voxel-based morphometry (VBM).Methods Nineteen children with 45XO karyotype TS,21 children with heterozygous TS and 20 age-matched control girls were recruited in this study.Wechsler intelligence scale for children was used to obtain their intelligence quotients (IQ).High-resolution magnetic MR imaging was performed in TS children and control girls to collect the whole brain structural data.The data was analyzed by VBM based on SPM8 to compare the volume of gray matter among the monosomy TS children,heterozygous TS children and normal controls by using covariance analysis.Alphasim method in the software of analysis of functional neuroimages(AFNI) was used for clusterlevel multiple comparison.Results The IQ was 89 ± 16 for the monosomy TS children,and it was 91 ± 13 for heterozygous TS children and 109 ± 15 for the controls.Statistical analysis revealed significant difference of IQ among them (F =10.75,P ＜ 0.05).Compared with normal controls,both monosomy TS children and heterozygous TS children showed significantly decreased volume (voxel numbers in clusters were 4117,1392,1085,t =5.75,5.33 and 5.02 for monosomy TS; voxel numbers in clusters were 4501,2437,591,t =5.40,5.11 and 4.95 for heterozygous TS respectively,P ＜ 0.01,FWE-corrected) in the gray matter of bilateral precuneus lobule,postcentral gyrus,and cingulum cortex.However,the volume of the orbitofrontal lobe,parahippocampal gyrus,cerebellum,temporal pole,corpus striatum and posterior midbrain were increased in the monosomy and heterozygous TS children compared to the controls (voxel numbers in clusters were 1444,1188,791,725,695,431,386,t =5.01,5.96,5.67,5.23,4.85,4.43,4.94 for monosomy TS; voxel numbers in clusters were 6988,2709,2510,2380,1987,1709,1185,t =6.50,7.06,7.26,5.27,5.71,6.02,4.56 for heterozygous TS,P ＜ 0.01,FWE-corrected).Compared with monosomy TS,heterozygous TS showed increased gray matter volume in the left parahippocampal gyrus and corpus striatum (voxel numbers were 1014 and 496,t =4.75,4.53,P ＜0.01,FWE-eorreeted),while they had decreased gray matter volume in the right supramarginal gyrus (voxel number was 350,t =4.28,P ＜ 0.01,FWE-corrected).Conclusions Both monosomy and heterozygous TS show brain atrophy in the parietooccipital lobe,indicating similar abnormality of gray matter development.However,heterozygous TS shows more increased gray matter volume in the prefrontal lobes and the cerebellum than monosomy TS,which may be the compensatory mechanism in this condition.

Objective To investigate the etiology, epidemiologic features and drug resistance tendency of acute infectious diarrhea among children in Beijing area. Methods Enteric pathogenic bacteria were isolated, cultured and identified for serotype from the stool specimens of children with the initial clinical diagnosis of acute bacterial diarrhea in the intestinal clinic from January to October in 2009 ,and the antibiotic susceptibility of bacteria was tested by disk diffusion method. The cluster A rotavirus antigen was also detected by the qualitative technique of immunochromatographic double-antibody sandwich assay. Results Of the 256 stool specimens, 87 strains of 4 species of pathogenic bacteria were detected with the detectable rate of 34. 0% ,of which 2 strains were detected in one stool sample ,including 40 strains of salmonella (46. 0%) ,23 strains of shigella (26. 4%) ,2 strains of diarrheogenic escherichia coli (2. 3%) and 22 strains of staphylococcus aureus (25.3%). The positively detected patients consisted of 54 males and 32 females with the ratio of 1.69∶1 ,of whom 55 cases (64. 0%) were under 2 years of age. Of the 13 strains of shigella, 13 were sonnei shigella (56. 5%). And of the 22 strains of staphylococcus aureus,20 were detected among the infants under 1 year of age. The rates of crug resistance to certain antibiotics were lower in salmonella than in shigella (ampicillin :65. 0% vs. 95.7% ;compound sulfamethoxazole:20. 0% vs. 78. 3% ;ciprofloxacin:7.5% vs.8. 7% ;ceftriaxone: 15.0% vs. 73.9%). Of the 256 stool specimens ,47 were found positive for cluster A rotavirus,of whom 13 were also positive in stool bacteria culture. Conclusion Salmonella is the major pathogen among children with bacterial diarrhea in Beijing in 2009, and sonnei shigella is the main epidemic strains of shigella diarrhea. lnfants under 2 years of age are the susceptible population of the above two species of bacteria, while staphylococcus aureus mainly infect the infants under 1 years of age. Multi-resistance in shigella is still serious. The incidence of mixed infections of bacteria and rotavirus increases in children with infectious diarrhea.