Objective To explore the effect of high bilirubin on myocardial injury.Methods The levels of serum total bilirubin (TBIL),creatine kinase (CK),creatine kinase-isoenzyme MB(CK-MB),cardiac troponin Ⅰ (cTnI) were measured and compared in newborns without obvious physiological jaundice (control group) and newborns with hyperbilirubinemia (study group) before and after treatment.Results Compared with those in control group,the levels of serum TBIL,CK,CK-MB and cTnI in study group before treatment were obvious higher[(270.24 ± 36.89) μ mol/L vs.(68.95 ± 10.87) μ mol/L,(414.27 ± 135.45)U/L vs.(178.35 ± 59.62) U/L,(63.31 ± 23.25) U/L vs.(16.78 ± 8.89) U/L,(0.39 ± 0.11) μ g/L vs.(0.18 ± 0.07) μ g/L],and the differences between two groups were statistically significant (P ＜ 0.05).The levels of serum TBIL,CK,CK-MB and cTnI after treatment in study group [(69.13 ±9.98) μmol/L,(183.35 ± 61.01) U/L,(17.45 ± 9.0.8) U/L,(0.19 ± 0.01) μ g/L] were decreased obviously compared with those before treatment,and the differences between two groups were statistically significant (P ＜ 0.05).There was no significant difference between control group and study group after treatment (P ＞ 0.05).Conclusions High bilirubin can lead to a reversible myocardial injury.Cardiac enzymes and troponin testing should be routinely done for neonatal hyperbilirubinemia.It suggests doctors to attend to the treatment of myocardial protection.

Objective To investigate the predictive value of umbilical cord blood bilirubin for pathological jaundice in healthy term newborns. Methods Two ml navel string vein blood of baby were collected after giving birth in the normal newborn, and the hemobilirubin was detected by accidentally oxidation method. After birth, the infant's bilirubin level was tested on the forehead by the transcutaneous bilirubinometer at 8:00 -9:00 every morning until discharging from hospital. The ration of pathological jaundice of newborn and its treatment were analyzed in different levels of cord blood hemobilirubin. Results Fifty-nine cases ( 22.96% ) with pathological jaundice were diagnosed in 257 newboms.The concentration of cord blood hemobilirubin in baby with pathological jaundice [(39.68 ±8.10) μmol/L] was significantly higher than that of the normal newborn [(30.05 ±5.51) μmol/L](P＜0.01). As the concentration of cord blood hemobilirubin was increased, the incidence of pathological jaundice was raised (P＜ 0.01), and the cases that needed to intervention treatment was increased(P＜ 0.01). Conclusion The detection of the level of cord blood hemobilirubin is not only very worthy to estimate the occurrence of pathological jaundice of newborn, but also offer reliable evidence for clinical early diagnosis and treatment.

Objective To investigate the diagnostic value of plasma cardiac troponin Ⅰ (cTnI) and brain natriuretic peptide (BNP) for heart failure complicated with pneumonia in children.Methods 30 children of heart failure complicated with pneumonia (heart failure group),30 children with pneumonia in acute phase (pneumonia group) and 30 healthy children (control group) were selected.The levels of plasma cTnI and BNP in the heart failure group were detected in acute phase(6-24h) and recovery phase(5-7d),and the results were compared with pneumonia group and control group.Results The levels of plasma cTnI and BNP in the heart failure group were significantly higher than those in the pneumonia group and control group(F =5.303,4.632,all P ＜ 0.05).The levels of plasma cTnI and BNP were not significantly different between the pneumonia group and control group(P ＞ 0.05).The levels of plasma cTnI and BNP in recovery phase of the heart failure group were significantly lower than those in acute phase of the heart failure group (t =4.291,5.393,all P ＜ 0.05),but there were no siganificant differences compared with the pneumonia group and control group(P ＞ 0.05).Conclusion The plasma cTnI and BNP maybe a reliable index in the diagnosis of heart failure complicated with pneumonia in children.

In this study,adults of Armillifer agkistrodontis (A.agkistrodontis) were collected from Agkistrodon acutus,and then the eggs were separated to feed mice.In the next step,when the infection model was established,blood serum of infected mice were collected after 1,2 and 3 weeks,respectively.Furthermore,ELISA and dot- ELISA were used to detect the dynamic change of specific antibodies and circulating antigens respectively.The specific antibodies increased from 8th week,reached the top at 12th week,decreased from 16th week,and then maintain at the same level constantly.Meanwhile,the specific antibodies were typed.It is evident that IgM antibody appeared first.However,it was substitute by IgG1 after 16 weeks.Moreover,the circulating antigens have been detected in the 1st week by dot-ELISA.Then,the dilution between 1:8 to 1:128were founded in 3rd week.The highest dilution with 1:256 appeared at 8th week,maintained before 11th week and then decreased gradually,which might provide a significant clinical implication for early diagnosis of circulating antigens.

Objective To investigate the alterations of dopamine,norepinephrine,cortisol,C-reactive protein (CRP),heart rate (HR),respiratory rate (RR) and mean artery pressure (MAP) before and after the laser photoeoagulation for retinopathy of prematurity (ROP) with topical anesthesia and to provide the guideline for improving its routine management and interventions.Methods Thirty children with ROP who received ROP laser photocoagulation in Guang zhou Women and Children's Medical Center from May to Dec.2012 were selected.The blood of the 30 cases of infants were collected at 4 time points:before laser therapy,the end of laser therapy,1 hour and 24 hours after laser therapy.The concentrations of dopamine,norepinephrine,cortisol and CRP in plasma were measured at each time point with radio immunoassay,and the values of HR,RR and MAP of infants were recorded as well.Results The levels of dopamine,norepinephrine and cortisol at the end and 1 hour after therapy were higher than those in the quiet state before therapy,and the differences were statistically significant (t =6.39,2.55 ; t =7.74,2.91 ; t =8.87,2.15 ; all P ＜ 0.05) ; the levels of CRP at the end of therapy,1 hour and 24 hours after therapy had no statistical difference in comparison with those in quiet state before therapy (t =0.06,0.89,1.16; all P ＞ 0.05) ; the levels of HR and RR at the end of therapy,1 hour and 24 hours after therapy had statistical difference in comparison with those in the quiet state before therapy (t =4.33,3.84,3.38 ; t =6.81,4.42,2.96 ; all P ＜ 0.05).The level of MAP at the end of therapy had statisti cal difference in comparison with that in the quiet state before therapy (t =6.10,P ＜ 0.001).Conclusions Infantswho experieneed ROP laser photocoagulation had stress response.Clinicians should pay more attention to monitoring HR and RR of preterm infants receiving retinal laser photocoagulation under topical anesthesia and take active intrvventions in order to relieve the stress response.

Objective To analyses the magnetic resonance imaging(MRI)findings of different clinical patterns of neurosyphilis(NS).Methods Clinical records and MRI of 26 patients with NS were retrospectively studied.Results Abnormal MRI was found in 17 patients of 26 patients with NS.In 7 patients were with meningo-vascular syphilis,the MRI commonly showed multiple cerebral ischemia focus and cerebral infarction focus,very few similar to those of encephalitis;Six patients had general paresis,who presented cerebral MRI abnormalities of frontal and temporal atrophy,and few simultaneously with cerebral ischemia focus,granular apendymitis and hippocampus sclerosis;Three patients had syphilitic myelitis,their MRI showed mild tumefaction with multiple ischemic focus all the way through lower cervical spinal cord to lower thoracic spinal cord:One patient was with tabes dorsalis,whose cerebral MRI showed ischemic locus.Another 9 patients had normal MRI,of whom 4 patients with meningitis NS and 5 with tabes dorsalis.Conclusion The MRI of neurosyphilis has diverse presentations,and clinicians should pay much attention to it.

Objective To investigate the clinical significance of detecting cardiac troponin Ⅰ (cTnⅠ) and CK -MB in children with hand-foot-and-mouth disease and myocardial injury.Methods 90 children with hand-foot-and-mouth disease (observation group) were detected the level of serum cTnⅠ and CK-MB.At the same time,40 healthy children were chosen as control group.Results Compared with the control group,the levels of CK-MB and cTnl in observation group were significantly higher than those of the control group (t =8.92,5.46,all P ＜ 0.01),which indicated that children with hand,foot and mouth disease was easier to merge myocardial injury.CK-MB and cTnl levels in high-risk group were significantly higher than those in normal children group (t =9.17,6.13,all P ＜ 0.01),and the levels of CK-MB and cTnl were positively correlated with severe degree (r =0.767,0.683,all P ＜ 0.01).For children with hand,foot and mouth disease merged myocarditis,cTnl diagnostic sensitivity (53.8％) was lower than that of CK-MB diagnostic sensitivity (71.8％),but the specificity was better than that of CK-MB,and the diagnosis of cTnl detection window 2 weeks longer than CK-MB,but after 2 weeks both lose their clinical diagnostic significance.Conclusion Children with hand,foot and mouth disease easily merge myocardial damage,dynamic measuring CK-MB and cTnl levels could help early diagnosis of children with hand,foot and mouth disease whether merged myocardial damage,both applications can also complement each other,more timely and accurate reflection of disease progression and recovery,it is worth promoting.

Background::Heterotaxy (HTX) is a thoracoabdominal organ anomaly syndrome and commonly accompanied by congenital heart disease (CHD). The aim of this study was to analyze rare copy number variations (CNVs) in a HTX/CHD cohort and to examine the potential mechanisms contributing to HTX/CHD.Methods::Chromosome microarray analysis was used to identify rare CNVs in a cohort of 120 unrelated HTX/CHD patients, and available samples from parents were used to confirm the inheritance pattern. Potential candidate genes in CNVs region were prioritized via the DECIPHER database, and PNPLA4 was identified as the leading candidate gene. To validate, we generated PNPLA4-overexpressing human induced pluripotent stem cell lines as well as pnpla4-overexpressing zebrafish model, followed by a series of transcriptomic, biochemical and cellular analyses. Results::Seventeen rare CNVs were identified in 15 of the 120 HTX/CHD patients (12.5%). Xp22.31 duplication was one of the inherited CNVs identified in this HTX/CHD cohort, and PNPLA4 in the Xp22.31 was a candidate gene associated with HTX/CHD. PNPLA4 is expressed in the lateral plate mesoderm, which is known to be critical for left/right embryonic patterning as well as cardiomyocyte differentiation, and in the neural crest cell lineage. Through a series of in vivo and in vitro analyses at the molecular and cellular levels, we revealed that the biological function of PNPLA4 is importantly involved in the primary cilia formation and function via its regulation of energy metabolism and mitochondria-mediated ATP production. Conclusions::Our findings demonstrated a significant association between CNVs and HTX/CHD. Our data strongly suggested that an increased genetic dose of PNPLA4 due to Xp22.31 duplication is a disease-causing risk factor for HTX/CHD.

Given the increasing exploitation of antibodies in different contexts such as molecular diagnostics and therapeutics, it would be beneficial to unravel properties of antigen-antibody interaction with modeling of computational protein-protein docking, especially, in the absence of a cocrystal structure. However, obtaining a native-like antigen-antibody structure remains challenging due in part to failing to reliably discriminate accurate from inaccurate structures among tens of thousands of decoys after computational docking with existing scoring function. We hypothesized that some important physicochemical and energetic features could be used to describe antigen-antibody interfaces and identify native-like antigen-antibody structure. We prepared a dataset, a subset of Protein-Protein Docking Benchmark Version 4.0, comprising 37 nonredundant 3D structures of antigen-antibody complexes, and used it to train and test multivariate logistic regression equation which took several important physicochemical and energetic features of decoys as dependent variables. Our results indicate that the ability to identify native-like structures of our method is superior to ZRANK and ZDOCK score for the subset of antigen-antibody complexes. And then, we use our method in workflow of predicting epitope of anti-Ebola glycoprotein monoclonal antibody-4G7 and identify three accurate residues in its epitope.