Abstact:Objective To explore the clinical characteristics of biliary pancreatitis in children.Methods The clinical data from 10 children with biliary pancreatitis from January 2011 to July 2015 were retrospectively analyzed.Result In 10 children (2 males and 8 females), the average age was 6.1?±?4.9 years old, and the average hospital stay was 8.4?±?3.8 d. There were 4 cases of gallstone, 4 cases of cholestasis, 2 cases of calculus of bile duct, 2 cases of choledochocyst and 1 case of pancreatic divisum. Abdominal pain was the main clinical manifestation in these 10 children. All of them had elevated serum amylase, with the maximum value of 106-922 U/L. Six cases had elevated lipase of 22-2000 U/L. Six cases had abnormal serum alanine aminotransferase. Two cases had hypokalemia. One case had hypoglycemia. Four cases had acid-base imbalance. Abdominal ultrasonography showed pancreatitis in 4 cases. CT showed pancreatitis in all children. All of the children were treated by fasting, lfuid infusion, maintaining water and electrolyte balance, inhibiting gastric acid by omeprazole and inhibiting pancreatic secretion by octreotide. Nine cases were improved by conservative treatment and discharged, and one case was transferred to surgery. Conclusion The incidence of biliary pancreatitis in children is low. The clinical manifestation is atypical. Pancreatic duct abnormalities are more common in young children, in whom the effect of conservative treatment is relatively good.

Objective To investigate the clinical features of acute pancreatitis (AP) in children of differem age.Methods From January 2010 to December 2015,pediatric inpatients with AP were searched by pediatric inpatient medical records retrieval system.According to age,patients were divided into three groups:infant and toddler group (age 0 years to three years),preschool group (age ＞three years to six years) and school-aged group (age ＞ six years to 16 years).The clinical features,etiology and laboratory findings of differem age groups were retrospectively analyzed.One-way analysis of variation or rank sum test was performed for measurement data analysis.Chi-square test or Fisher exact probability test was used for the count data analysis.Results A total of 88 pediatric patients (male 38,female 50) were enrolled,and the mean age was (8.8±4.4) years.Infant and toddler group,preschool group and schoobaged group were 16,14,58 cases,respectively.The average days of hospitalization of infant and toddler group,preschool group and school-aged group were (8.4±1.9),(9.4±2.6) and (7.5± 2.5) days,respectively,and the difference was statistically significant (F=3.649,P=0.030).About 93.2％ (82/88) pediatric patients had abdominal pain.The incidence rate of epigastric distention of school-aged group (34.5％,20/58) was higher than those of infant and toddler group (2/16) and preschool-aged group (1/14).The rate of nausea/vomiting of infant and toddler group was significantly higher than those of preschool group and school-aged group (12/16,4/14 and 46.6 ％ (27/58),respectively),and the differences were both statistically significant (x2 =6.250 and 6.805,both P＜0.05).Biliary pancreatitis was the main etiology of infant and toddler group and preschool group,and the incidence was 6/16 and 6/14,respectively.Whereas,there was a variety of etiologies in school-aged group.There were 20 cases (22.7％) of severe AP.The severe cases were more in the infant and toddler group and preschool group (7/16 and 6/14,respectively),and less in school-aged group (12.1％,7/58).There was no statistically significant difference among the three age groups in blood amylase level,lipase level,white blood cells count,blood glucose level,blood calcium level and blood urea nitrogen (all P＞0.05).The percentage of obese children of school-aged group was significantly higher than those of infant and toddler group and preschool group (31.0％,18/58;1/16 and 1/14,respectively),and the difference was statistically significant (x2 =6.689,P=0.035).In addition,the level of serum total cholesterol of school aged group was higher than that of infant and toddler group and preschool group ((5.1±0.9),(3.9±0.6) and (4.8±0.8) mmol/L,respectively),and the difference was statistically significant (F =13.855,P＜ 0.01).The positive rates of abdominal ultrasound of infant and toddler group,preschool group and school-aged group were 5/16,4/14 and 21.1％ (12/57),respectively,and there was no statistically significant difference (x2 =0.889,P 0.706).The positive rates of magnetic resonance cholangiopancreatography (MRCP) of infant and toddler group and school-aged group were 4/4 and 5/6,respectively,and which were both higher than those of pancreases computed tomography (CT) examination (4/14 and 51.2％,22/43) and those of abdominal ultrasound (5/16 and 21.1％,12/57),and the differences were significant (x2 =6.655 and 15.207,both P＜0.05).Conclusions Obese children is more in school-aged children with AP.Children of this age should pay more attention to life style.Nausea or vomiting symptom is more obvious in the infant and toddler children with AP and the condition is more severe.If children of this age with unexplainable vomiting,AP should be considered.Biliary factors are more common in the infant and toddler children with AP.When children are suspected with abnormal structure of pancreatic and biliary ductal system,MRCP should be conducted.

Objective In order to raise the clinicians' recognition of biliary pancreatitis in children,the clinical features between children with biliary pancreatitis and those with non-biliary pancreatitis were compared.Methods In this retrospective study,a total of 88 children with acute pancreatitis(AP)were enrolled,who stayed at the Department of Pediatrics,Tianjin Nankai Hospital from January 2010 to December 2015.The clinical characteristics,biochemical index(amylase,lipase,glucose,calcium,hepatic and renal function)and imageology examination [pancreatic ultrasound,pancreatic computed tomography,magnetic resonance cholangiopancreatography(MRCP)] were analyzed and evaluated.The etiology of biliary pancreatitis was analyzed.In addition,the clinical features,laboratory examinations and imageology between the children with biliary pancreatitis and those with non-biliary pancreatitis were also compared.Then,multiple Logistic regression analysis was conducted to identify the factors which were significantly associated with biliary pancreatitis independently.Results Of the 88 cases,there were 68 cases of non-biliary pancreatitis,aged(9.5±4.2)years,and 20 cases of biliary pancreatitis,aged(6.7±4.5)years,who represented the plurality(22.7％),including 9 cases of anatomic abnormalities and 11 cases of choledocholithiasis,cholecystolithiasis and cholestasis.Compared with children of non-biliary pancreatitis,children with biliary pancreatitis had more severe condition,there was statistically significance between 2 groups(x2=23.313,P=0.000).However,there was no statistically significance between 2 groups related to the gender,course of disease,hospitalization time,body mass index(BMI)percentile and clinical symptoms(all P>0.05).Children with biliary pancreatitis showed higher levels of serum amylase,serum lipase and urine amylase than those with non-biliary pancreatitis,and there were statistically significances between 2 groups(Z=-3.535,-3.980,-2.952,P=0.000,0.000,0.003).In addition,children with biliary pancreatitis had higher levels of alanin aminotransferase(ALT),aspartate aminotransferase(AST)than those with non-biliary pancreatitis,and there were statistically significances between 2 groups(Z=-5.625,-2.341,P=0.000,0.019).However,total bilirubin did not differ significantly between 2 groups(Z=-0.453,P=0.650).There was no statistically significance between 2 groups in relation to white blood cell count,C-reactive protein(CRP),lactate dehydrogenase(LDH),blood urea nitrogen(BUN),creatinine(Cr),calcium and glucose(all P>0.05).Of the 88 cases,all children with AP were fasting,fluid and electrolyte supplementation,acid suppression of omeprazole,and octreotide by conservative treatment,which was an inhibitor of exocrine pancreatic secretion.In addition,children with AP should be given intravenous antibiotics covering gram-negative bacteria in the early stage.Children with non-biliary pancreatitis had better prognosis than those with biliary pancreatitis,and there was a statistical significance between 2 groups(P=0.000).Children with non-biliary pancreatitis had lower recurrence risk than those with biliary pancreatitis,and there was a statistical significance between 2 groups(x2=4.778,P=0.044).The positive rate was higher by abdominal ultrasound(45.0％)and computed tomography(CT)(81.2％)in biliary pancreatitis group than those with non-biliary pan-creatitis group(17.9％,35.2％),and there were statistical significances between 2 groups(x2=4.782,10.554,P=0.029,0.002).However,there was no statistical significance in relation to MRCP between the biliary pancreatitis group(83.3％)and the non-biliary pancreatitis group(85.7％)(P=1.000).In multiple Logistic regression analysis,ALT was an independent predictor of biliary pancreatitis(OR=0.896,P=0.001).Conclusions ALT is the significant risk factor for predicting biliary pancreatitis over other etiology.A biliary cause should be suspected in children with AP who are presented with high levels of ALT.These findings will spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.

Objective To observe the effect of human telomerase reverse transcriptase-thymidine kinase/ganciclovir (phTERT-TK/GCV) system combined human telomerase reverse transcriptase-tumstatin (phTERT-tumstatin) system on apoptosis of human HepG2 and mRNA expression and protein content of AFP,RhoC related with cancer.Methods Fluorescence microscopy was used to observe expression of EGFP and MCHERRY in transfected HepG2 and L-02.Real-time PCR and Western blot were used to detect AFP and RhoC mRNA and protein content.Flow cytometry was used to detect the apoptosis of transfected HepG2.Results phTERT-tumstatin and phTERT-TK/GCV genes expressed in transfected HepG2.Real-time PCR showed that AFP and RhoC mRNA expression in different group were 0.76±0.09 and 0.80±0.04 (TK/GCV group),0.62±0.09 and 0.40±0.02 (TM group),0.49±0.07 and 0.54±0.03 (MK group).The differences were significant (P ＜ 0.01) except TK/GCV group compared with empty plasmid group.Western blot test results showed that protein content of AFP and RhoC were higher in TK/GCV group (0.97±0.02/1.17± 0.01),TM group (0.83±0.02/0.99±0.02),MK group (0.69±0.01/0.77±0.02) than in empty plasmid group (1.19±0.03/1.32±0.05) and non-transfected group (1.15±0.05/1.29±0.30) (P ＜ 0.01).Additionally,protein content of AFP and RhoC in MK group were significant difference with TK/GCV group and TM group (P ＜ 0.01).Flow cytometry showed that phTERT-tumstatin,phTERT-TK/GCV co-transfected HepG2 cells apoptosis rate was significantly higher than both individually transected group.Cells apoptosis rate of alone and co-transfected groups was significant difference compared with empty vector group and untransfected group.Conclusions The effect of phTERT-TK/GCV and phTERT-tumstatin on pro-apoptotic of HepG2 cells is significant.phTERT-TK/GCV combined with phTERT-tumstatin has strong therapeutic function.

Objective To observe if IL-2 gene can express in hepatic carcinoma cells by double targeting of hepatitis B virus envelope (HBVE) and alpha fetoprotein (AFP) promoter.Methods HepG2 cells,L02 cells,and HepG2.2.15 cells were cultured in vitro.HBVE was obtained by PEG8000 concentration assay,and the acquired HBVE was used to pack recombintional gene.Human AFP promoter-IL-2 recombinational gene was obtained by PCR.Then HepG2 cells and L02 cells were transfected by transient transfection and the expression of IL-2 was detected by RT-PCR and Western blot.Results IL-2 was detected in HepG2 cells by RT-PCR and Western blot but not in L02 cells.Conclusion By using HBVE as a gene transporter,human AFP promoter-IL-2 recombinational gene can express in hepatic carcinoma cells,thereby it can increase the safety of exogenous gene transfection of hepatic carcinoma cells.

An introduction of principle of chromatographic fingerprint spectrum and its application on guality standard of Chinese drug. The chromatogram is digitiged by its relative retention value. The digitized chromatogrzaphic fingerprint specturm of some chinese drug was obtained. This technic can be used to reseasch guality standard of chinese drug sucessfully.

Objective To study the relationship between the level of serum total bile acid(TBA)and fetal distress of intrahepatic cholestasis pregnancy(ICP).Methods 357 patients with ICP were devided into two groups,fetal distress group and non-fetal distress group.Their levels of TBA were collected retrospectively.Results The incidence rates of fetal distress rose with the increasing level of TBA.As the level of TBA was over 35umou/L,the incidence rates of fetal distress rose significantly.Conclusion The study suggest that the level of TBA maybe one of sensitive marker to preditect fetal distress.

To observe the therapeutic e ects of Fufangbiejiasan on patients with hepatocirrhosis of Child-Pugh B.Methods:Eighty-eight patients with hepatocirrhosis of Child-Pugh B,Chronic Hepatitis B were enrolled,and divided into two groups,treated with Fufangbiejiasan and Binglian Jianganlin capsule respectively.The therapeutic course was 3 years for both groups.Liver function,HBV.DNA,AFP and CT/MRI were examined at 6th,12th,24th and 36th month after treatment.Results:Levels of blood albumin were markedly increased in Fufangbiejiasan group after treatment at 6th,12th,36th month(38.5?2.1),(39.1 ?3.9),(40.8?3.4)g/L while those in Binglian Jianganlin group were reduced(28.9?1.6),(28.8?1.7),(25.6?1.5)g/L.Level of PTA in Fufangbiejiasan group was signi cantly higher than those in controls;Compared with controls,Fufangbiejiasan treatment was more e ective :34(77.3),41(93.2),42(95.5) and 0(0),0(0),0(0)(P

Objective To observe the effect of dexamethasone on the levels of IL-12 and IL-13 in bronchoaveolar la-vage fluid (BALF) and serum in rats with Mycoplasma pneumoniae (MP) infection. To explore the mechanism of treatment MP pneumonia by dexamethasone. Methods A total of one hundred rats were randomly divided into four groups:azithromycin in-tervened group (n=25); dexamethasone intervened group (n=25); azithromycin and dexamethasone combination intervened group (n=25);control group (n=25). The rat model of MP pneumonia was established by dropping pneumonia bacterial liquid to its nasal cavity on day 0, 1, 2, and 3. Four groups received different interventions at the second day when the model was estab-lished successfully. Amounts of IL-12 and IL-13 in BALF and serum were measured by ELISA, the inflammatory infiltration of lung tissues was evaluated on day 3, 5 and 8. Results Compared with the control group, the expression of IL-12 and IL-13 in se-rum and BALF in azithromycin intervened group and combination intervened group had a significant difference (P<0.05) on day 3, 5 and 8. Amount of IL-12 in serum in combination intervened group was higher than azithromycin intervened group on day 3, whereas IL-13 was lower than that in azithromycin intervened group (P<0.05). Conclusions Dexamethasone can relieve inflammatory infiltration of lung tissues in rats.

Objective To study the effects of extensively hydrolyzed formula forvery/extremely low birth weight(VLBW/ELBW)infants.Methods From Jun.2013 to Oct.2015,78VLBW/ELBW infants admitted to our hospital within 12 hours of birth were randomly assigned into two groups:hydrolyzed protein formula feeding group ( hydrolyzed formula group) and preterm formula feeding group (control group). Infants with hospital stay <28 days were excluded. Prospective study was conducted between two groups comparing the duration of meconium discharge, the time required for total enteral feeding average hospital stay, feeding intolerance and physical growth and blood biochemical indices on the28thday.Results A total of 78 infants were enrolled,35 in hydrolyzed formula group and 43 in control group. Comparing with control group, feeding intolerance in hydrolyzed formula group was significantly lower ( 25. 7℅ vs. 72. 0℅) . The duration of meconium discharge [ ( 4. 9 ± 0. 8 ) d vs. (8. 8 ± 1. 6)d], the time required for total enteral feeding[(13. 4 ± 2. 0) d vs. (18. 9 ± 2. 6) d] and average hospital stay duration [ ( 33. 7 ± 5. 1 ) d vs. ( 41. 8 ± 6. 8 ) d ] was shorter in hydrolyzed formula group ( P<0. 05). The body length on the 28th day in hydrolyzed formula group was longer than control group[ (43. 8 ± 1. 2 ) cm vs. ( 42. 6 ± 2. 0 ) cm, P < 0. 05 ] . The concentration of serum albumin [ (32. 5 ± 3. 0 ) g/L vs. ( 30. 0 ± 4. 5 ) g/L ] and hemoglobin [ ( 112. 4 ± 11. 4 ) g/L vs. ( 106. 3 ± 13. 0) g/L] in hydrolyzed formula group were significantly higher than the control group( P<0. 05). No significant difference was found between the two groups regarding the time required returning to birth weight [(10. 9 ±2. 2)d vs. (10. 1 ±1. 7)d],body weight [(1759 ±107)g vs. (1627 ±435)g], head circumference[(30. 3 ± 1. 0)cm vs. (29. 7 ± 1. 6)cm] on the 28th day and the incidence of extrauterine growthretardation(EUGR)(40.0℅vs.44.1℅)atdischarge.Conclusions Comparing with preterm formula feeding, early feeding with extensively hydrolyzed formula can reduce the incidence of feeding intolerance on VLBW/ELBW infants. Extensively hydrolyzed formula also can accelerate meconium discharge, reduce hospital stay duration and the time required for total enteral feeding. But the growth of weight and head circumference on the 28th day and the incidence of EUGR at discharge were not altered by extensively hydrolyzed formula.