Objective To study the efficacy and safety of pulmonary surfactant used in hyaline membrane disease(HMD)of newborn treatment.Methods 67 cases of HMD children were treated.And pulmonary surfactant was used by intratracheal instillation.Clinical manifestation,blood gas analysis,X-ray chest film and complication before and after treatment were observed and recorded.Results 65 cases of children were recovered and discharged(97.01％),while 2 cases were dead.The PO2 increased significantly after the surfactant was given(P＜0.05),while the PCO2 decreased significantly(P＜0.05),and situation of skin cyanosis was relieved.X-ray chest films in 24 hours showed that 62 cases were improved(92.54％),while 4 cases were not obvious(5.97％),and there was hemorrhage image in the last 1 caes(1.49％).There were 5 cases of complication,involving 3 cases of pneumonia,1 case of intracranial hemorrhage and 1 case of pulmonary hemorrhage.Conclusion Clinical symptoms could be impurved rapidly,pulmonary oxygenation could be ameliorated,the need of mechanical ventilation could be lower and the rate of incidence of complication and death could be reduced effectively by using pulmonary surfactant early.

Central nervous system (CNS) damage caused by enterovirus 71 (EV71) infection is the main reason for its mortality and morbidity.In recent years,survival rate of EV71 infection-associated CNS damage in children is improved.However,the condition of survivors with sequelae is still unclear.It is important to understand its prognosis in order to improve the life quality of children with CNS damage after EV71 infection.In this paper,the prognosis and sequelae classifications of EV71 infection-associated CNS damage are described.

Enterovirus 71 (EV71) is one of the most important causes of hand-foot-mouth disease and herpangina.EV71,due to its neurotropic nature,can also cause severe complications of the central nervous system than other types of enterovirus.EV71 infection also causes devastating syndromes such as acute pulmonary edema,pulmonary hemorrhage and cardiopulmonary failure.In this review,clinical manifestations and the pathogenesis of central nervous system dysfunction after EV71 infection were described.

BACKGROUND:Studies have shown that human umbilical cord mesenchymal stem cel s can improve pulmonary ventilation function by reducing inflammations. OBJECTIVE:To observe the therapeutic effect of human umbilical cord mesenchymal stem cel transplantation on acute lung injury. METHODS:Thirty Sprague-Dawley rats were randomized into normal group, model group and experimental group. Rats in the latter two groups were used to establish animal models of acute lung injury by intratracheal instil ation of lipopolysaccharide. One hour after modeling, rats in the experimental group were intratracheal y administered human umbilical cord mesenchymal stem cel suspension (0.1 mL, 1×106 cel s), and those in the other two groups were given normal saline in the same dose intratracheal y. Twenty-four hours after treatment, the pathological changes of lung tissue were observed using hematoxylin-eosin staining;the wet and dry weight ratio of the lung tissue and the levels of serum interleukin-1 and interleukin-8 were detected. RESULTS AND CONCLUSION:Compared with the normal group, the wet and dry weight ratio of the lung tissue and the levels of serum interleukin-1 and interleukin-8 were significantly increased in the model group (P<0.05), while compared with the model group, these levels were significantly decreased in the experimental group (P<0.05). Hematoxylin-eosin staining results showed clear alveolar space structure with complete alveolar septum in the normal group. In the model group, the alveolar septum was markedly thickened, and there was visible pulmonary capil ary hyperemia, edema, as wel as a large amount of inflammatory cel infiltrations in the pulmonary capil aries and alveolar space. Edema fluid rich in proteins was observed in a part of the pulmonary alveoli, and an extensive transparent membrane formed in the alveolar space. In the experimental group, the alveolar structure was clear, but the alveolar septum became thickened, and red blood cel s and a smal amount of infiltrated inflammatory cel s were leaked from the pulmonary interstitial tissue. In conclusion, human umbilical cord mesenchymal stem cel transplantation for treatment of acute lung injury can reduce inflammatory factor levels and al eviate lung injury.

Objective:This study aimed to investigate the relationship between estrogen receptor (ER) and Bcl-2 in cervical can-cer and precancerous lesions. Methods:ER and Bcl-2 were evaluated by immunohistochemistry in 20 non-tumor tissues, 30 low-grade cervical intraepithelial neoplasias, 70 high-grade cervical intraepithelial neoplasias, and 80 cervical cancers. Results:The positive rate of ER was 75%in non-tumor tissues;this rate decreased with disease severity (χ2=24.266, P<0.01). The overexpression of ER protein was remarkably lower in cervical intraepithelial neoplasias (CIN) Ⅱ-Ⅲ and carcinomas than in non-tumorous cervices. Differences were not significant between CINⅠand non-tumorous cervices (χ2=0.751, P=0.386). Furthermore, ER expression was not correlated with histological type and tumor grade. The positive rate of Bcl-2 was 75.38%in squamous cell carcinoma. This rate increased with dis-ease severity (χ2=27.715, P<0.01). The Bcl-2 protein overexpression was remarkably higher in CINⅠ, CINⅡ-Ⅲ, and carcinomas than in non-tumorous cervices. Bcl-2 expression was also not correlated with histological type (P=0.500);by comparison, Bcl-2 expression was correlated with tumor pathological grade (χ2=4.862, P=0.027). The co-expression of ER and Bcl-2 was 38.57%and 15.38%in CINⅡ-Ⅲand squamous cell carcinoma, respectively;the differences between these two values were significant (χ2=9.108, P=0.003). A cor-relation between ER and Bcl-2 was observed in CINⅡ-Ⅲ(r=0.506, P<0.01);no correlation was observed between other groups. Con-clusion: ER expression was inversely correlated with Bcl-2 in cervical cancer progression. The co-expression of these markers may have an important function in the course of high-grade cervical intraepithelial neoplasia.

ObjectiveTo investigate the diagnosis and operative procedure for spontaneous perforation of congenital choledochal cyst in children. MethodsThe clinical data of 16 cases with spontaneous perforation of congenital choledochal cyst were analysed retrospectively.ResultsAll cases were under 4 years old with a mean age of 23 months. Abdominal distension, pain, vomiting, fever and diffuse tenderness were present in all patients. The preoperative diagnosis was established by paracentesis in ten patients. Abdominal sonography and CT found a cyst in 5 of the 10 cases reviewed. In 11 cases (68.7%), the site of perforation was found on the confluence of common bile duct and gallbladder cystic duct. T-tube drainage was used as a transition measure. All patients recovered uneventfully. Radical resection was performed in about three months after the initial operation. ConclusionsThe obstruction of the bile duct and poor blood supply to the choledochal cyst are major causes leading to perforation. Routine abdominal paracentesis should be carried out for a small child with peritonitis and general abdominal tenderness, especially on the right upper quadrant.T-tube drainage should be adopted as an emergent procedure to tide the patient over the crisis followed by elective choledochal cyst resection and bile duct reconstruction.

Objective Study of peripherally inserted central catheter (PICC) for low birth weight infant parenteral nutrition effect. Methods A total of 100 low birth weight infants were selected, and then divided into the study group and the control group with 50 cases in each group according to random number table method. The study group used PICC for intravenous nutrition support treatment, the control group using external support for the treatment of indwelling needle for nutrition week vein. Comparing the two groups of one-time success rate of catheterization, average operation time, indwelling time, incidence of complications and nutritional support before and after the treatment, the children of weight. Results The one-time success rate of catheterization between the two groups had no significant difference (P >0.05). The operation time and the indwelling time in the study group was(30.65±9.87) d, (23.47±6.38) d respectively, while in the control group was (3.26±1.09) d, (4.15±1.52) d respectively, the difference was significant between the two groups (t=19.054 and 20.829, P<0.01). The incidence of complications in the study group was 8.00%(4/50), while in the control group was 24.00%(12/50), the difference was significant between the two groups (χ2=4.76, P<0.05). There was no significant difference about weight between the two groups before and after the nutritional support treatment (P > 0.05). Conclusions Parenteral nutritional support by PICC for low birth weight infant is a more ideal way with longer indwelling time and fewer complications.

OBJECTIVE:To establish a method for the dissolution determination of Tamibarotene tablet. METHODS:HPLC was performed on the column of Diamonsil C18 with mobile phase of methanol-water-acetic acid(85∶15∶1,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 235 nm,column temperature was 25 ℃,and injection volume was 20 μl. The paddle method was used to determine the dissolution,using pH6.8 phosphate buffer dissolution as medium,medium volume was 900 ml,the rotat-ing speed was 50 r/min,taking samples after 60 min. RESULTS:The linear range of tamibarotene was 0.801-2.804 μg/ml (r=0.999 6);RSDs of precision,stability and reproducibility tests were lower than 3%;recovery was 99.58%-100.90%(RSD=0.25%,n=9);the accumulative dissolution rate of 3 batches of samples was 98.25%,96.54%,92.38%(n=6). CONCLUSIONS:The method simple,accurate with high sensitivity and specificity,and suitable for the dissolution determination of Tamibarotene tablet.

Objective To observe the clinical effect by using insulin detemir therapy in children and adolescents with type 1 diabetes mellitus(T1DM).Methods Thirty children and adolescents with T1DM were divided into 2 groups to receive Humulin R and Determir(observation group,n =15) or Humulin R and neutral protamine hagedorn (NPH) (control group,n =15)insulin therapy.Daily insulin dose,glycemic variability,incidence of non-severe and severe hypoglycemia events after the institution of insulin therapy were collected.Results The daily doses of insulin were (1.16 ± 0.30) U/kg in the observation group and(1.21 ± 0.35) U/kg in the control group,respectively.There was no clinically important change between 2 groups(t =0.526,P ＞ 0.05).Within-subject variation in fasting plasma glucose was significantly lower in observation group(29％)than that in control group(65％) (t =5.296,P ＜0.01).One case of severe hypoglycemia event occurred in the observation group,but 5 cases occurred in the control group(t =4.863,P ＜ 0.0l).Two cases of nocturnal hypoglycaemia(22:00-7:00) events occurred in the observation group,7 cases occurred in the control group(t =4.506,P ＜ 0.01).Conclusions Institution of insulin detemir therapy is associated with low within-subject variation in fasting plasma glucose and decreased rates of severe and nocturnal hypoglycemia while dose of insulin did not increase.This makes insulin detemir a valuable new tool for the treatment of children and adolescents with T1 DM.

Objective To study the impact of methionine restriction (MetR) on mucosal histopathology,permeability and tight junction composition in a dextran sulfate sodium (DSS)-induced colitis model,and to explore its underlying mechanism.Methods SD rats were randomly divided into 4 groups:normal rats fed by a complete amino acid (AA group) diet,normal rats fed by MetR diet (MetR group),DSS treated rats fed by a complete amino acid (DSS + AA group) and DSS treated rats fed by MetR diet (DSS + MetR group),each group had 15 rats.Abdominal aorta blood sampling was taken at day 21 after DSS model been established to analyze blood routine examination,liver and kidney function and level of electrolyte.Morphological changes in colonic mucosa were evaluated and scored by light microscopy.Myeloperoxidase (MPO) activity was measured.The effect of MetR on mucosal permeability of colon strips was detected by Ussing chamber.Claudin2,occludin,claudin3,ZO-1 expression were quantified by Western blot.Results The early clinical manifestation in the DSS treated rats were loose stool or diarrhea,hematochezia positive and bleeding,and weight losing.HE observation showed prominent colitis in distal colon with manifestations of crypt abscess and infiltration of inflammatory cells.Although MPO activity and WBC account between the DSS + MetR and DSS + AA group did not significantly changed,treatment with MetR diet significantly decreased the extent and severity of epithelial injury of DSS + MetR group (10.55 ± 3.62 vs 15.00 ± 4.89,P =0.003).There were no significant difference in PCNA immunohistochemical result between the DSS + MetR group and DSS + AA group.Compared to the rats on AA diet,transepithelial electrical resistance(TEER) in DSS + AA group was obvious lower [(28.40 ± 6.78) Ω · cm2 vs (46.53 ± 4.03)Ω · cm2,P ＜0.05],and TEER in MetR group were obviously higher[(60.64 ± 8.40)Ω · cm2 vs (46.53 ±4.03)Ω · cm2,P ＜0.05].However,short-circuit current (Isc) in DSS + MetR group was obviously higher that of DSS + AA group [(35.01 ± 2.19) μA/cm2 vs (29.61 ± 1.19) μA/cm2,P ＜0.05].Western blot suggested that colon claudin2 expression was not found in colon epithelium of normal rats,and an obviously increase expression of claudin3 protein was found in the MetR group,compared to AA group; and an significantly increase in the abundance of claudin3 was found in the DSS + MetR group,but amount of claudin2 was decreased,compared with the DSS + MetR group.Conclusion The MetR diet has obvious therapeutic effect on ulcerative colitis model rats induced by DSS,and its mechanism may not by regnlating inflammatory cell infiltration and the way of promoting intestinal cell growth to alleviate inflammatory injury,but probably by changing the structure and function of tight junction protein and improve the intestinal mucosal barrier function,and promote the repair of damaged intestinal mucosa.