Objective To observe clinical curative effect of long-acting recombinant human growth hormone(rhGH)and short-acting rhGH,and their influences on growth and development indexes,serum thyroid function indexes and insulin in children with idiopathic short stature(ISS).Methods The children with ISS were randomly divided into long-acting group[subcutaneous injection of polyethylene glycol recombinant human growth hormone(0.2 mg·kg-1·w-1,qw)]and short-acting group[subcutaneous injection of recombinant human growth hormone(0.15 U·kg-1·d-1)at 30 min before sleep every night].All children were treated for 12 months.The growth and development[growth velocity(GV),height standard deviation of points(Ht SDS)],thyroid function,fasting insulin(FINS)and insulin-like growth factor-1(IGF-1)were compared between the two groups.The occurrence of adverse reactions was recorded.Results In the 68 children,there were 4 cases with loss to follow-up and shedding due to personal reasons.Finally,there were 33 cases in long-acting group and 31 cases in short-acting group for statistical analysis.After 6 months of treatment,GV in long-acting group and short-acting group were(4.53±0.56)and(3.97±0.48)cm·year-1,Ht SDS were-2.45±0.23 and-2.66±0.21,IGF-1 levels were(551.62±41.48)and(524.36±37.84)mg·mL-1,respectively.After 12 months of treatment,GV in long-acting group and the short-acting group were(9.44±0.82)and(8.46±0.77)cm·year-1,Ht SDS were-1.68±0.19 and-1.91±0.20,IGF-1 levels were(642.46±36.49)and(593.14±40.12)mg·mL-1,differences were statistically significant(all P＜0.05).There were no significant differences in FT3,FT4,TSH and FINS between the two groups after treatment(all P＞0.05).There was no significant difference in the total incidences of adverse drug reactions between long-acting group and short-acting group[6.06％(2 cases/33 cases)vs 12.90％(4 cases/31 cases),P＞0.05].Conclusion Compared with short-acting rhGH,promotion effect of long-acting rhGH is better on short-term growth and development in ISS children,which can increase level of serum IGF-1 and has no obvious effects on thyroid function,with good safety.

OBJECTIVETo analyze the causes and the clinical characteristics of the neonatal inspiratory dyspnea; so to raise the diagnosis and cure rate of the disease.

METHODSEleven new born infants with severe inspiratory dyspnea were investigated from March, 2001 to June, 2004 in Shenzhen children's hospital. Six infants were male and 5 were female. The average age was 7.2 days ( range from 8 hours to 28 days). Four cases were hospitalized with trachea intubation. Three of them can not cry, and 2 cases were diagnosed as bilateral vocal cord paralysis, 1 case as multiple cranial nerve palsy with direct laryngoscopy. Two cases couldn't drink milk continuously and accompanied with deteriorated inspiratory dyspnea, and were diagnosed as congenital adenoid hypertrophy and neonatal rhinitis respectively with compute tomography and magnetic resonance imaging. Among the 6 cases with persistent inspiratory dyspnea, four of them were diagnosed as congenital laryngocele by direct laryngoscope, one case was diagnosed as subglottic stenosis by tracheoscopy and one case was confirmed to be thoracic tracheostenosis when tracheotomy performed.

RESULTSFour congenital laryngoceles and one case congenital adenoid hypertrophy were cured with surgery. Two bilateral vocal cord paralysies and one case of subglottic stenosis received tracheotomy. One neonatal rhinitis case applied 0.25% ephedrine. One case of thoracal tracheostenosis died. The parents of the infant with multiple cranial nerve palsy refused to accept any treatment.

CONCLUSIONSThe laryngoscope examination is recommended for patients with neonatal inspiratory dyspnea. It is necessary for patients with persistent dyspnea to be examined by tracheoscopy as early as possible.

Dyspnea ; diagnosis ; etiology ; therapy ; Female ; Humans ; Infant, Newborn ; Laryngoscopy ; Male

Objective To evaluate the incidence of postoperative hemorrahage in children undergoing adenoidectomy , and to discuss its possible causes. Methods Included in this study were children who underwent adenoid and/or tonsil surgery at Shenzhen Chilidren's Hospital between January 2004 and November 2009. The change of hemoglobin ( Hb) and hematocrit ( Hct) were retrospectively analysed. The blood loss was estimated by the change of Hct. Results There were 2078 cases that accomplished the inclusion criteria in the period of study. Ten children bled 0. 5 - 4. 0 hours after surgery,without superfluous hemorrahage during the operation and post-tonsillectomy. This represented an incidence of 0.48% of immediate postoperative haemorrhage among the 2078 procedures analyzed. Statistical differences were found between boys (0.21%) and girls (1.10%, x2 =5.597, P<0.05). The change of Hb and Hct was positively correlated (r = 0. 95 , P < 0. 01) , the blood loss was positively correlated with the bleeding time ( r = 0. 66, P < 0. 05 ) . The causes of postoperative hemorrhage were coagulation system deficits, chronic nasopharyngitis, deficient hemostasis and immoderate ravage. To control the postoperative hemorrhage, 2 postnasal packing under topical anaesthesia and 8 electrocautery under general anaesthesia were applied. Conclusions Poor operative technique and deficient hemostasis are the major causes of primary hemorrahage. Prompt operation to control the postoperative bleeding should be done 2 hours after bleeding under general anesthesia in order to avoid severe complications.

Objective To investigate the relationship between impaired glucose tolerance(IGT)and carotid atheromatous plague in patients with acute cerebral infarction and analyze the risk factors for plaque formation.Methods The 326 patients hospitalized in our department for acute cerebral infarction were divided into diabetes mellitus(DM)group,IGT group and normal glucose tolerance (NGT)group.The clinical features,biochemical indices and results of Doppler ultrasound examination of the carotid artery were compared between the 3 groups.Results The body mass index(BMI),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)of IGT group were markedly higher than those in NGT group(P＜0.05).Both the IGT and DM group showed significantly increased carotid intimal-medial thickness,plaque detection rate and the incidence of carotid scleratheroma in comparison with the NGT group(P＜0.05).Logistic regressive analysis identified age,TC,LDL-C and 2-h postprandial serum glucose as the independent risk factors for carotid scleratheroma.Conclusion In patients with acute cerebral infarction,those having impaired glucose often show obvious carotid scleratheroma with a severity similar to that in the DM patients.

Medicinal botanical gardens play important roles in promoting the development of TCM industry. With the advancing of the construction of the national medicinal plant garden system, the upgrading construction work for Huazhong Medicinal Botanical Garden, one of its members, is grasping to be carried on. While it is believed that there is a tremendous potential development in the combination of selenium and Chinese herbal medicine. In this article, the significance of selenium for Huazhong Medicinal Botanical Garden was investigated and then the routes to highlight selenium characteristics in its upgrading construction were put forward as follows for some responsibility department as reference: (1) Concentrating on the background investigation and conserving selenium resources;(2) Selecting and breeding special germplasm materials associated with selenium for selected key species; (3) Aiming at the specific efficiency and screening selenium-enriched medical plants; (4) Selecting large varieties of TCM and carrying out the research of selenium-rich technical ways of artificial cultivation; (5) Propelling the research and development of selenium-containing health products, based on resources industrialization; (6) Constructing new specialized garden for selenium-enriched medical plants.

BACKGROUND: Amniotic membrane has a unique structure that can block the penetration of certain substances, to ensure normal nutrition supply for the surrounded tissues, and is also characterized by anti-adhesion, good tissue compatibility, mild inflammatory reaction, few fibers and biodegradability. OBJECTIVE: To compare the effects of fresh amniotic membrane and acellular amniotic membrane to prevent adhesion and promote tendon healing during the repair of tendon sheath defects. METHODS: Sixty healthy male leghorn chickens were selected, and the model of tendon injury and tendon sheath defects was established at the third toes. The animal models were then randomly divided into three groups and underwent repair with fresh amniotic membrane (group A), acellular amniotic membrane (group B), and no treatment in control group (group C), respectively. Histological observation and biomechanical analysis of the third toes were performed after repair. RESULTS AND CONCLUSION: (1) Histological observation. Congestive edema and inflammatory response were found in all animals at 2 weeks after repair, but mildest in the group A and severest in the group C. These inflammatory responses gradually alleviated over time in the three groups. At 12 weeks after repair, the new tendon sheath formed in all the animals, which was more mature than that at 4 weeks after repair. The synovial cells on the surface of the tendon sheath were arrayed tidily with dense structure in the groups A and B, but in the group C, the synovial cells were distributed disorderly with loose structure and prominent fibrous tissues. (2) Biomechanical analysis. Tendon sliding distance in the groups A and B was significantly larger than that in the group C at 4, 8, 12 weeks after repair (P < 0.05), but there were no significant difference in the distance between the groups A and B (P > 0.05). At 4 and 8 weeks after repair, the maximum tensile strength was largest in the group A, sequentially followed by group B and group C (P < 0.05), but there were no significant difference among the three groups at 12 weeks after repair (P > 0.05). To conclude, both fresh amniotic membrane and acellular amniotic membrane can promote tendon healing and prevent the adhesion of tendon through tendon sheath reconstruction, but the fresh amniotic membrane is preferred to promote early tendon healing compared with acellular amniotic membrane.

BACKGROUNDThe mammalian target of rapamycin (mTOR) pathway, a key cellular signaling pathway associated with various cellular functions, has distinct roles in the inflammatory process. In this study, the mTOR inhibitor rapamycin (Rapa) was used to test whether inhibition of mTOR activation attenuates lipopolysaccharide (LPS)-induced acute lung injury (ALI) in a murine model.

METHODSMice pretreated with Rapa or vehicle were given LPS intratracheally. Local cell numbers and inflammatory cytokines present in the bronchoalveolar lavage fluid (BAL), wet-to-dry weight ratio, histopathology of the lungs, and survival were evaluated.

RESULTSThe phosphorylation of S6, a major downstream target of mTOR, had a 3-fold increase in lung tissue after LPS stimulation, but the increase was blocked by Rapa. Rapa reduced the levels of TNF-α (LPS vs. LPS + Rapa, (1672.74 ± 193.73) vs. (539.17 ± 140.48) pg/ml, respectively; P < 0.01) and IL-6 (LPS vs. LPS + Rapa: (7790.88 ± 1170.54) vs. (1968.57 ± 474.62) pg/ml, respectively; P < 0.01) in the BAL fluid. However, Rapa had limited effects on the overall severity of ALI, as determined by the wet-to-dry weight ratio of the lungs, number of neutrophils in the BAL fluid, and changes in histopathology. In addition, Rapa failed to reduce mortality in the LPS-induced ALI model.

CONCLUSIONSWe confirmed that mTOR was activated during LPS-induced ALI and strongly inhibited by Rapa. Although Rapa reduced the levels of the mediators of inflammation, the overall severity and survival of the ALI murine model were unchanged.

Acute Lung Injury ; chemically induced ; drug therapy ; Animals ; Lipopolysaccharides ; Mice ; Mice, Inbred C57BL ; Phosphorylation ; Sirolimus ; pharmacology ; therapeutic use ; TOR Serine-Threonine Kinases ; drug effects

Objective To evaluate the feasibility and safety of CO2 laser supraglottoplasty for severe laryngomalacia in infants.Methods From January 2009 to December 2011,32 infants with severe laryngomalacia were confirmed by electronic laryngoscope and clinical assessment in Shenzhen Children's Hospital.According to the choice made by the parents,16 children accepted CO2 laser supraglottoplasty (group 1),the others were treated conservatively (group 2).The beginning observation point TO was defined as the age on the first medicine taking day or the age of surgery.T1,T3,T6 were defined as 1,3,6 months following TO.Clinical symptoms included stridor,dyspnea,aspiration,and respiratory infections.The body weight,PSG reports,laryngoscope findings,cure rates of the two groups were compared.Results The anatomical abnormalities were corrected surgically,and the symptoms,such as stridor,dyspnea,and aspiration improved rapidly after the operation.The cure rates was higher in group 1 than in group 2 on T1,T3,T6 stage.There were statistically significant differences(x2 were 13.9,28.1,24.6 respectively; all P ＜ 0.01).Children in group 1 gained weight better than in group 2.There was a statistically significant difference in Z scores median on T1,T3,T6 stage (z score were-0.848,-2.940,-4.110 ; P ＜ 0.05,or P ＜ 0.01 respectively).The lowest oxygen saturation in group 1 improved one month after the surgery (from average 0.686 ±0.106 to 0.901 ±0.041).There was a statistically significant difference (t =-7.876,P =0.001).Complications included adhesion (1 case) and temporary new-onset aspiration (1 case).Conclusions The CO2 laser supraglottoplasty can resolve severe laryngomalacia symptoms including stridor,dyspnea and aspiration.It can reduce the frequency of respiratory infections,and contribute to weight gaining.The CO2 laser supraglottoplasty is effective,of high security and with rare complications.

Objective： The aim of this study was to investigate the method of large-scale screening for genes differentially expressed in nonfunctional pituitary tumor and normal pituitary. Methods： cDNA libraries of nonfunctional pituitary tumor (NFPT) and human normal pituitary were constructed. Large-scale sequencing, bioinformatics and semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) were used. Significant difference of known genes expression in 2 tissues were analyzed by statistical software offered by Audic S and Claverie JM (http： //igs-server.cnrs-mrs.fr/). Results： A total of 1253 and 7222 ESTs with good quality were obtained from the tissues of NFPT and normal pituitary, respectively. Two hundred known genes were found in NFPT. Among them, 38 genes creditability of significant difference expression in the 2 tissues were over 0.99, and 130 were over 0.95. Out of the 130 differentially expressed genes in the 2 tissues, 17 genes were associated with cell differentiation and development (G2). 6 differentially expressed G2 category genes were selected and the liability of the expression significant difference in the 2 tissues was confirmed by semi-quantitative RT-PCR. Out of them, 4 were confirmed differentially expressed in the 2 tissues. Conclusion： MEIS2, SMT3C, C1D, and BUB3 genes associated with cell differentiation and development (G2) were expressed more in nonfunctional pituitary tumor than in normal pituitary. They may play a role in the pathogenesis of nonfunctional pituitary carcinoma.

BACKGROUND & OBJECTIVE: Postoperative tissue adherence, scarring and radiotherapy often lead to extrinsic compression and stricture in the distal ureter of the patients who had history of pelvic malignancies. Our aim was to evaluate the efficacy and safety of endourologic techniques in treating this kind of ureteral obstruction. METHODS: From Jan. 1998 to Mar. 2007, 46 patients with obstruction in the distal ureter and had history of pelvic malignancies underwent endoscopic treatments at the Third Affiliated Hospital of Sun Yat-sen University for relief of the obstruction. Perioperative and follow-up data were analyzed. RESULTS: Of the 46 patients, 25 underwent laparoscopic ureterolysis and ureteroneocystostomy, 18 underwent placement of ureter stent under ureteroscope, 3 underwent percutaneous nephrostomy. No severe complication was recorded. The mean operating time was 82.5 min (range, 30-140 min). The mean blood loss was 45.5 ml (range, 5-180 ml). No blood transfusion was needed. The median follow-up time was 18.2 months (range, 3 months to 6.5 years). Three months after operation, B-ultrasonography and intravenous urography (IVU) showed that 39 (84.8%) patients had recovered normal renal function, the other 7 (15.2%) had hydronephrosis relief and renal function improvement. Nuclear renal scanning showed that the mean postoperative glomerular filtration rate (GFR) in the obstructive kidney was higher than the preoperative level (37.6 ml/min vs. 21.3 ml/min, P＜0.05). No stricture in the uretero-bladder anastomotic stoma was recorded. CONCLUSION: Endoscopic operation is an effective and feasible option for managing some selected kinds of distal ureteral obstruction caused by postoperative tissue adherence and radiotherapy in the patients with history of pelvic malignancies.