Objective To evaluate the changes of IL-1β and IL-lra in hippocampus of rats with frequent febrile seizures(FS).Methods 21-day-old male Sprague-Dawley(SD)rats were randomly divided into 3 groups:normal control group(NC group),hyperthermic control group(HC group)and febrile seizures group(FS group).IL-1β and IL-1ra levels in hippocampus of these rats were determined by ELISA methods,IL-1β mRNA and IL-1ra mRNA levels in hippocampus were measured by RT-PCR.Results IL-1β mRNA and protein levels in hippocampus of rats in FS group were significantly higher than those in NC group and HC group(P＜0.01,P＜0.05).IL-1ra mRNA and protein levels in hippocampus of rats in FS group were significantly higher than those in NC group and HC group(P＜0.01,P＜0.05),too.IL-1ra/IL-1β protein ratio showed no significant difference among 3 groups.Conclusion Frequent FS can cause the increase of IL-1β and IL-lra mRNA and protein levels in hippocampus,suggesting that IL-1β and IL-1ra may be involved in the pathogenesis of hippocampal neuron damage in FS rat.

Objective To explore the changes of plasma melatonin(MT)level in hypoxic-ischemic encephalopathy(HIE)neonates,and elucidate the function of rnelatonin in the pathogenesis and the prognosis of HIE.Methods Fourty HIE neonates were divided into 2 groups,20 mild HIE neonates and 20 moderate or severe HIE ones.The femoral vein blood were collected in 48 h and on 7 d after birth in mild HIE group,and in 48 h,on 7 d and(14±4)d after birth in moderate on severe HIE group.Twenty normal term infants served as control group.The level of plasma MT was determined with enzyme-labeled immunosorbent assay.Results Compared with control group[(8.003±1.840)ng/L],The MT level in mild HIE group in 48 h after birth[(13.311±4.025)ng/L]was higher(P＜0.01),but there was no difference on 7 d[(6.605±1.269)ng/L](P＞0.05);The MT level in moderate or severe HIE group in 48 h after birth[(5.487±1.997)ng/L]was lower(P＜0.01),but it was higher on 7 d[(16.201±5.594)ng/L](P＜0.01),there was no difference on(14±4)d[(6.799±1.765)ng/L](P＞0.05).Conclusion MT may have protective action on HIE.The prognosis of HIE with rising MT level in 48 h after birth is better than that with lower MT level.

Objective To explore the risk factors of ventilator-associated pneumonia(VAP)in neonatal patients.Methods A retrospective study was conducted on the 82 neonates who had ever received mechanical ventilation for more than 48 hours,non-conditional logistic regression analysis was performed to determine independent predictors for VAP.Results By logistic regression analysis,the following risk factors independently predicted VAP:gestational age(OR = 6.209,95%CI =2.112～16.835),duration of mechanical ventilation(OR =5.842,95%CI = 1.366～14.936),times of endotracheal suctioning(OR =4.764,95%CI = 1.416～14.736),re-intubation(OR = 6.190,95%CI = 1.669～16.019),gastric tubes retention(OR =6.794,95%CI = 1.928～19.160),treatment with CNS suppressant(OR = 4.297,95%CI = 1.002～15.216).Conclusion The neonatal VAP occoured for multiple facors,the rsik factors include gestational age,duration of mechanical ventilation,endotracheal suctioning,re-intubadon,gastric tubes retention and treatment with CNS suppressant.

Objective To identify predictive factors of survival to in-hospital children with post-cardiorespiratory arrest.Methods Eighty-seven patients who had cardiorespiratory arrest(CRA)and received cardiopulmonary resuscitation(CPR)were reviewed from January 2006 to December 2008.The clinical data was analyzed to identify predictive factors of survival by Pearson X~2 test and multivariate and unconditioned Logistic regression analysis.Results Forty-three of eighty-seven cases received return of spontaneous circulation,the initial sunvival rate was 48.3%,31(35.6%)cases survived for 24 hours,19(21.8%)cases survived to hospital discharge.Primary diseases and complications,the type of arrest,tracheal intubation or not,the duration of CPR,the dose of adrenaline,the body temperature post-resuscitation for 24 hours,the glucose post resuscitation for 6 hours and complications were obviously associated with both initial and long-term survival.Logistic regression analysis revealed that primary diseases and the duration of CPR were predictive factors of both survival for 24 hours and hospital discharge,additionally,the body temperature post-resuscitation for 24 hours were predictive factor of survival to hospital discharge.Conclusion Initial and long-term survival rate of in-hospital children with post-resuscitation was both low.Primary diseases and complications,good quality CPR and management of post-resuscitation affect survival,especially primary diseases and the duration of CPR may predict initial survival and primary diseases,the duration of CPR and the body temperature post-resuscitation for 24 hours may predict long-term survival.

Influenza A(H1N1)virus is a re-mixed strains of human influenza virus genes,avian influenza virus gene and swine influenza virus gene.Influenza A(H1N1)pandemic influenza has spread around the world,which has drawn worldwide attention.In order to early discovery,early diagnosis,early treatment and effective prevention of Influenza A(H1N1),we describe the characteristics of linfluenza A(H1N1)virus,epidemiology,pathogenesis,clinical manifestations,laboratory examination and effective treatment and preventive measures.

Mechanical ventilation plays an important role in the treatment of preterm infants,especially respiratory problems.With improvement in both antenatal and neonatal care and therapeutic strategies,premature babies are surviving more than ever.However,the incidence of bronchpulmonary dysplasia remains high which affects the clihical outcomes of premature infants.Non-invasive respiratory support techniques have been used in attempts to decrease lung injury and the complications of preterm infants.This review will focus on various ventilation modalities for managing preterm infants with respiratory failure and lung protective ventilation strategies to minimize lung injury in preterm infants.

Objective To investigate the correlation between exhaled nitric oxide and lung function (FEV1)in asthmatic children.Methods Fifty three stable asthmatic children aged 5 to 14 years old were recruited from ShengJing Hospital of China Medical University.According to whether the patients were treated with inhaled corticosteroid(ICS)therapy regularly,they were divided into two groups:steroid group and non-steroid group,then fraction of exhaled nitric oxide(FeNO)and lung function were measured.Results In non-steroid group,the levels of FeNO(mean 40.450±25.428 part by billion)were significantly higher than those in the steroid group(mean 19.879±13.845 part by billion),and they were statistically significant.(P = 0.003).The mean FEVI in non-steroid group was(95.152±8.993)%,and the mean FEVI in non-steroid group was(91.350±11.690)%,and there were no significant differences between two groups (P =0.189).Significantly negative correlation was found between FeNO and FEV1 in steroid group(r =-0.465,P = 0.039),but there was no significant correlation between them in steroid group(r = 0.058,P =0.747).Conclusion The levels of FeNO were higher in non-steroid group than those of the steroid group in the stable asthmatic children.FeNO is a good biomarker to evaluate the airway inflammation of asthmatic children.

Objective To investigate the clinical significance of serum cystatin C(CysC)level in the diagnosis of renal damage in critically ill children.Methods One handred and forty-two critically ill children admitted to the Boai Hospital pediatric intensive care unit from January 2007 to December 2008 were included in the study.CysC,serum creafinine(SCr)and creatinine clearance rate(Ccr)were collected and analyzed.Pediatric critical illness scoring was done to assess the degree of disease.Renal damage was established according to Ccr＜80 ml/(min·1.73 m~2)(traditional gold standard)and CysC＞1.50 mg/L.The receiver operating characteristic(ROC)was analyzed to get the best point value of the diagnosis,and evaluated its sensitivity and specificity.Results According to the Ccr and CysC standards,the incidence of renal injury were 40.8%(58/142)and 50.7%(72/142),respectively(χ~2 =64.93,P＜0.001);ROC curve analysis showed that the best diagnosis point of renal injury was 1.55 mg/L;sensitivity of 94.8%,specificity 81.0%.Area under the ROC curve was 0.98(95%CI 0.97～0.98),for the diagnosis of renal damage in critically ill children was statistically significant(P=0.000).Conclusion Serum cystatin C level is a better marker of renal damage than the Ccr,can increase the diagnostic sensitivity and specificity.of renal damage in critically ill children.

The development of cardiovascular system in very premature infants is immature.Hypotension and patent ductus arteriosus are common problems in the few days of life.The enormous difference that these infants receive cardiovascular support may affect the morbidity and mortality.Volume expansion,inotropes,cyclooxygenase inhibitor and glucocorticoid is commonly used drugs,but when and how to treat for these extremely low birth weight infants with cardiovascular problems has been plagued by clinical doctors.

The survival of extremely low birth weight infants has increased significantly due to improvement in both scientific knowledge and technology.Lung protective ventilatory strategies have been used for these infants in attempts to decrease lung injury severity and the incidence of bronchopulmonary dysplasia.The modalities of respiratory support will depend on the status of birth.It is important to apply these techniques correctly to achieve adequate gas exchange and avoid ventilatory injury.Non-invasive ventilatory support shows valuable as an initial intervention after birth and is an effective alternative to endotracheal intubation or mechanical ventilatory treatment.