Objective:To investigate the different function of macrophage between patients with asthma and healthy control , and discuss the pathogenesis of the disease .Methods:Choose 50 healthy controls ,50 patients with asthma , and isolation of blood mac-rophage.Then samples were induced with GM-CSF, and cells were collected on day 7.Macrophage function was evaluated using the following methods:fluorescence-activated cell sorting analysis for cell surface markers and phagocytosis ;enzyme-linked immunosorbent assay for cytokine production and the induction of T cell .Results: Compared with the control group , asthma group had decreased CD64, CD11c, CD40 expression, and increased CD206, CD14, CD23 expression(P<0.05);displayed the decreased IL-10 level(P<0.05 );displayed a decreased phagocytosis ability ( P<0.05 );when co-cultured with T cells , the supernatantdisplayed the increased IL-4 expression , and decreased IFN-γlevel ( P<0.05 ) .Conclusion: Compared with the control group , macrophage in asthma group displayed M2 phenotype, which inditates macrophage play the important role in the pathogenesis of asthma .

Objective To study the clinical significance of the changes of brain natriuretic peptide(BNP) in children with incomplete Kawasaki disease (IKD). Methods Of 25 cases of acute IKD ,20 cases were at the re-covery stage after 2 weeks treatment. 30 cases of upper respiratory tract infection at the same period were taken as controls. The plasma level of BNP,peripheral blood WBC count and C-reaction protein (CRP) levels were detected. Results BNP, WBC and CRP levels in acute IKD children were higher than that of control group (P < 0.01) , which were higher in 20 cases of acute phase than in recovery phase (P < 0.01). Conclusion BNP contributes to the early diagnosis of IKD in children.

Objective To evaluated T-wave characteristics in newborn infants with different gestational age. Methods One hundred and forty-two newborn infants were divided into four groups based on the gestation age consisting of the 28～30 weeks group,31～33 weeks group,34～36 weeks group and 37～40weeks group, respectively. The T-wave characteristics of electrocardiogram were compared among the newborn infants of four groups. Results TV1 amplitudes ( mV, median ( interquartile range) ) of 4 groups were -0. 10( -0. 30～0. 10), -0. 10( -0. 30～0. 15), -0. 10( -0. 45～0. 25 ) and 0. 10( -0. 30～0. 70) ,respectively. There was a statistical elevation of TV1 amplitude with the increase of the gestational age. TV5 amplitudes( mV, median ( interquartile range ) ) of 4 groups were 0. 10 ( - 0. 10～0. 30), 0. 10 ( - 0. 20～0. 30) ,0. 15( -0. 05～0. 25) and 0. 10( -0. 10～0. 50) ,respectively. No significant differences of TV5 amplitudes were found among 4 groups. The incidences of low or inverted T-waves in leads I and aVL, or low and flat T-waves in all leads reduced significantly with the increase of the gestational age. Conclusion The TV1 amplitude and the incidence of abnormal T-wave in newborn infants are correlated to the gestational age,and TV5 amplitude is not correlated to the gestational age.

objective To explore the indication of mechanical ventilation and evaluate the effects of mechanical ventilation with the least delay on the Severe cases of hand-foot-mouth disease(HFMD).Methods Retrospective cohort study was conducted among the severe HFMD cases(n=66)admitted to pediatric intensive care unit(PICU)between July 2008 and september 2009.Sixty-six cases were divided into two groups:42 cases(group A,July 5 to October 31,2008)were ventilated with the common mechanical ventilation,24 cases(group B,April 21 to september 30,2009)were ventilated at least delay when the symptoms of neurogenic pulmonary edema appeared.Then the diffcrences on the survival rate and the mortality in the group A and group B were investigated.Results Twenty out of 42 patients died(47.6%),eighteen were cured(42.6%) and four showed improved signs(9.5%)in group A.Twenty-two out of 24 patients were cured(91.7%),two showed improved signs(8.3%)and no death in group B.The clinical effect of group B was much better tllan group A(P<0.001).Conclusion Early mechanical ventilation would improve the survival rate and decrease the mortality of severe hand-foot-mouth disease.

Objective To explore the clinical features and risk factors of children with severe hand foot and mouth disease (HFMD).Methods The clinical data of 68 children with HFMD associated with brainstem encephalitis were analysed retrospectively from Apr to Sep 2010.Results Among the 68 cases,63cases(92.6％ ) were younger than 3 years.The major symptoms and physical signs of 68 cases included rash (68 cases,100％ ),fever (68 cases,100％ ),fatigue (68 cases,100％ ),irritability (65 cases,95.6％ ),somnolence (42 cases,61.8％ ),vomiting (28 cases,41.2％ ),limb tremor (23 cases,33.8％ ),tendon reflexe hyperactivity (60 cases,88.2％ ),tachypnea or respiratory rhythm abnormality (63 cases,92.6％ ),tachycardia (65 cases,95.6％ ),and hypertension (54 cases,79.4％ ).Twenty-five cases (36.8％,25/68 ) had leucocytosis ( ＞ 12 × 109/L ),and 19 cases ( 27.9％,19/68 ) had hyperglycaemia.X-ray appearances:patchy and pathy shadows in single or bilateral pulmonary were seen in 46 cases( 67.6％,46/68 ).Forty-eight cases were examined by MRI,eight cases displayed ischemic lesions or demyelination.Spinal cord MRI was performed in 3 cases with flaccid paralysis,which showed demyelination.The etiology indicated that 38 cases ( 55.9％,38/68 ) were infected by enterovirus 71,25 cases( 36.8％,25/68 ) were infected by other enterovirus,5 cases (7.3％,5/68) were negative.All the cases were treated by mechanical ventilation with tracheal intubation,in whom 63 cases recovered well,4 cases improved,and 1 case gave up to die.Conclusion Ages ＜ 3 years,enterovirus 71 infection,continual fever,fatigue,somnolence,irdtability,vomiting,limb tremor,tendon reflexes hyperactivity,tachypnea or respiratory rhythm abnormality,tachycardia and hypertension are the high risks of critically ill children associated with severe HFMD.To reduce the fatality rate of HFMD,it is crucial to early judge the high risk factors,and take mechanical ventilations earlier.

Objective To study the expression and significance of multidrug resistance gene (MDR1) in children with refractory epilepsy (RE). Methods Children with RE (n = 30), non-RE (n = 30) and healthy children (n=30) were collected. The expression of MDR1-mRNA in peripheral blood was analyzed by fluorescence quantitative PCR. The relationship of MDRI-mRNA with epileptic frequency and numbers of antiepileptic drugs (AEDs) were observed. Results The expression of MDR1 in RE group obviously increased when compared with that of non-RE group and healthy group (P < 0.01, P < 0.01) ; MDR1 expression was more among patients with high frequent epilepsy than patients with low frequent epilepsy (P < 0.01) ; more in patients administered with four kinds of AEDs than those with two or three kinds of AEDs (P < 0.01). Concinsions MDR1 overexpression in blood of children with RE may be linked to drug-resistant mechanism of RE. It might be used as a clinical indicator of RE.