Kawasaki disease ( KD) is an acute febrile systemic vasculitic syndrome. Since there is no specific diagnostic test for KD, the diagnosis is mainly based on the clinical menifetations according to the criterias and excluding of other diseases. Recently the value of plasma brain natriuretic peptide ( BNP) in the diagnosis of KD has been paid more attention gradually. The plasma NT-proBNP level is significantly elevated in KD patients in the acute phase. It is of some specificity and sensitivity, and it may due to the local myocardial inflammation, cytokines and diastolic function of left ventricular. This review summarizes the mechanisms by which the elevated levels of plasma NT-proBNP occur in the acute phase of KD.

The incident of colorectal cancer are closely related to factors such as genetics, life styles, dietary patterns, external environment, enteral environment, and exercise. Epidemiological studies of geographic regions with different eating habits have shown that the incidence of CRC varies as diets change. Further studies are needed to investigate the underlying mechanisms

ObjectiveTo assess the energy expenditure status in critically ill children on mechanical ventilation.MethodsFifty critically ill children on mechanical ventilation were enrolled in this study.Resting energy expenditure (REE) on days 1,3,5,and 7 were measured.The predictive REE was calculated for each subject using age-appropriate equations (Schofield-HTWT).ResultsREE on day 1 and Schofield-HTWT equation predictive REE were (96.80 ± 42.63 ) and ( 110.67 ± 38.35 ) kJ/d,respectively.REE on days 1,3,5,and 7 were (100.53 ±50.24),(113.80 ±49.19),(117.99 ±50.57),and (115.05±50.18) kJ/d,respectively (F =1.267,P =0.292).The REE of day 1 in children with congenital heart disease (CHD) and without CHD was (75.66 ± 31.23 ) and ( 113.40 ± 28.40) kJ/d,respectively ( F =10.423,P =0.002).ConclusionsThe hypometabolic response is apparent in critically ill children with mechanical ventilation,and the energy expenditure shows no time-specific change within the first week.The energy expenditure in children with CHD is lower than those without CHD.

Objective To study the diterpenoids possessed immunosuppressive activity from Tripterygium hypoglaucum. Methods The chemical constituents were isolated from the CHCl3 extracts of T. hypoglaucum by repeated column chromatography, including silica gel, Sephadex LH-20, and preparative HPLC. Their structures were elucidated on the basis of spectroscopic studies. The immunosuppressive activity of these compounds was tested using the lymphocyte transformation test. Results Compounds Ⅰ-Ⅵ were identified as triptobenzene H (Ⅰ), triptoquinone A (Ⅱ), triptoquinone B (Ⅲ), triptoquinone H (Ⅳ), triptonediol (Ⅴ), triptonoterpene (Ⅵ). Conclusion Compound Ⅰ-Ⅲ are isolated from this medicinal plant for the first time and all the compounds show the significant immunosuppressive activity.

Objective To establish the method of the GC fingerprints for Ligusticum chuanxiong essential oil and its quality control.Methods The temperature at both feed inlet and detector was 250℃,the carrier gas was nitrogen,and the flow rate was 2 mL/min.GC of the essential oil in ten batches of L.chuanxiong was analyzed by adopting temprature programmer and the fingerprint peaks were identified by GC-MS.Results To set up the GC fingerprints for L.chuanxiong essential oil,13 peaks were marked out altogether and the GC fingerprints were analyzed by similarity analysis.Conclusion The method is of high degree of presion,reproducibility,and stability.The resolving of each component in the essential oil is good.The established fingerprints could be used as one of the quality control index for L.chuanxiong essential oil.

AIM:To study the parameters of supercritical CO_2 extraction of essential oil from valeriana efficinalis by orthogonal design. METHODS: Four factors,such as extraction pressure,extraction temperature,extraction time and separation temperature were chosen by the observation of orthogonal design,each factor was assigned to three levels.Bornyl acetate content was selected as a marker in a position to determine optimal extraction. RESULTS: Pressure and temperature were the main factors in effecting the extraction of bornyl acetate,extraction time was minor factor relatively. CONCLUSION: The optimal extraction is as follow,parameters were extraction pressure:12 MPa,extraction temperature:45 ℃,extraction time:1 hour,separation temperature:35 ℃,it gave the best recoveries of essential oils and bornylacetate.

Objective To investigate the correlation between Framingham stroke risk profile(FSRP) and vascular cognitive impairment in stroke-free patients with cerebrovascular risk factors.Methods One hundred and eighty-four stroke-free subjects,selected from Zhejiang hospital,were divided into low risk group (56 subjects),moderate risk group (70 subjects) and high risk group (58 subjects) according to their FSRP score,and their cognitive function including memory ability,attention,executive function and language ability were assessed by Montreal cognitive assessment (MoCA),auditory verbal learning test (AVLT),digit symbol test,trail making test(TMT),digit span and verbal fluency test.Results The total MoCA scores which were (7.2±4.6),(13.8±3.9),(29.6± 12.7) respectively,AVLT-delay recall scores which were(8.2± 1.6),(6.7± 1.4),(5.9± 1.5) respectively,and digit symbol test score which were(34.7±9.3),(32.6± 16.4),(29.7± 13.6) respectively in low,intermediate and high risk groups,decreased with the increasing risk of stroke(P＜0.05).The elapsed time in TMT-B which were (115.2 ±36.9) s,(147.6±44.8) s,(173.9±58.5) s respectively in low,intermediate and high risk groups,prolonged with the increasing risk of stroke (P＜0.05).FSRP was associated with cognitive function,but inversely related to MoCA,AVLT-delay recall,digit symbol test,TMT-B and digit span fall back (P＜0.05),but positively related to consuming time in TMT-B (P＜ 0.05).Multivariate regression analysis showed that advanced age,hypertension,diabetes and smoking were the risk factors for vascular cognitive impairment(P＜0.05).Conclusion Advanced age,smoking,hypertension and diabetes are the most important in vascular risk factors for cognitive impairment.Vascular risk factors can damage cognitive function with the increased risk of stroke,among which delayed recall and executive function are the main affected cognitive area.

Objective To investigate the clinical manifestations of the febrile neutropenia cancer children,explore the relationship between the clinical data and sepsis.Methods A prospective observation study was employed,and 66 cancer children complicated with febrile and neutropenia after chemotherapy were enrolled.Sixty-six cases were divided into two groups:septic group ( n =26 ) and non-septic group ( n =40).Clinical and laboratory data were collected and compared.Results Body temperature,neutropenia duration,absolute neutrophic count ( ANC ),C-reactive protein ( CRP ),procalcitonin (PCT) and culture positive rate showed statistically differences between the septic and non-septic groups ( P ＜ 0.05 ).Body temperature ＞40 ℃,ANC ＜ 0.1 × 109/L,increases of serum CRP and PCT levels and positive culture were correlated with sepsis.Body temperature ＜ 39 ℃,neutropenia duration ＜ 5 ds,ANC ＞ 0.5 × 109/L were less correlated with sepsis.Conclusion High initial temperature,long duration of neutropenia,severely reduced ANC,increases of CRP and PCT,and culture-positive are correlated with sepsis in cancer children.

Objective To investigate the changes of plasma activated protein C(APC)in the pediatric leukemia patients with acute lung injury(ALI),and the relationship with the outcome.Methods During the study period(from Jan to Dec 2009),17 pediatric leukemia patients with ALI were selected.They were divided into neutropenic(n =10)and non-neutropenic(n =7)group.We collected the basic data including the age,gender,stage of chemotherapy,pediatric critical illness score,mechanical ventilation time,ICU time.The blood gas and plasma APC levels were detected on day 1 and day 4 of ALI onset.Results Compared with the non-neutropenic group,the neutropenic group had a significantly longer mechanical ventilation time [(16.60 ± 1 0.83)d vs(3.79 ± 4.08)d,P =0.009 6],lower PaO2 level on day l[(54.90 ± 17.05)mm Hg vs (92.70 ± 27.53)mm Hg,P =0.009 7],and lower APC level on day 4[(193.06 ± 63.19)pg/mlvs(286.28 ±25.12)pg/ml,P =0.007 7].Conclusion The APC generation is severely impaired in the neutropenic group,especially in those who died.The lower APC level is,the longer is the mechanical ventilation time,the worse is oxygenation,the poorer is the prognosis.APC replacement therapy may be promising in these patients.

Objective: To study the effect of wortmannin (WM), a PI3K/Akt inhibitor, on the proliferation and apoptosis of leukemia cells and the possible mechanism. Methods: Human leukemia cell line K562 was treated with different concentrations of WM. The proliferation of K562 cells was examined by MTT assay. DNA damage in K562 cells was examined by single cell gel electrophoresis assay, and apoptosis of K562 cells was detected by Annexin V-FITC/PI double-staining. The expressions of total Akt, phosphorate-Akt (p-Akt), and NF-κB p65 mRNA and protein were detected by RT-PCR and Western blotting, respectively. Results: WM inhibited the proliferation of K562 cells in a dose- and time-dependent manner, with the IC((50) value of 24 h being 25 nmol/L. WM also induced apoptosis of K562 cells in a dose-dependent manner. DNA damage in K562 cells was demonstrated by appearance of comet tail after treatment with WM, with the rate of DNA tail and the tail length being significantly higher than those in the control group (P<0.01). WM dose-dependently inhibited P-Akt and NF-κB p65, but not the total Akt, mRNA and protein expressions. Conclusion: WM can inhibit proliferation and induce apoptosis of K562 cells in a dose- and time-dependent manner, probably through down-regulation of phosphorate PI3K/Akt signal pathway and NF-κB expression.