Objective To investigate the clinical features and treatment programs in children with Takayasu arteritis (TA) in order to improve awareness of the disease. Methods A retrospective study of hospi-talized children with TA in our hospital from Jan. 1999 to Dec. 2012 was performed. Results Between the 15 patients with TA, the ratio of male to female was 1∶2. The onset was from 14 months to 15 years old, with average age at (10 ±4) years old. It is according to (the European League against Rheumatism/the Pediatric Rheumatology European Society (EULAR/PRES) criteria for the diagnosis of TA. The most common clinical manifestations are hypertension, which occurred in 13 cases(87%), weak pulse or pulseless in 11 cases (73%), and heart failure in 10 cases (67%). About two-thirds of patients were diagnosed when the onset of heart failure occurred. The most common clinical type was type Ⅱ, which occrred in 9 cases (60%). Antihypertensive drugs, oral steroid and congestive heart failure controlling were the main treatment. Three patients with positive purifiedproteinderivative (PPD) test received anti-TB treatment. Three patients had vascular bypass surgery, one patient had percutaneous transluminal angioplasty. Conclusion TA may be life-threatening and progressive. Many patients are with advanced disease at the time of treatment, so the prognosis is generally poor. Early recognition is necessary to initiate appropriate therapy. The disease should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without local signs.

Objective To investigate the safety and efficacy of stent insertion combined with high-intensity focused ultrasound(HIFU) ablation for malignant obstructive jaundice caused by pancreatic carcinoma.Methods From January 2013 to February 2017,a total of 80 patients with malignant obstructive jaundice caused by pancreatic carcinoma underwent biliary stent insertion in our center,who were divided into combined treatment(stent insertion with HIFU ablation) group(n=38) and solitary stent insertion group(n=42).The stent patency time and survival time were compared between the two groups.Results Relief of jaundice were archived in all patients in both groups.Cholangitis was observed in 7 cases in both two groups.Reobstruction of stent was observed in 15 patients in both two groups.The median stent patency time was 179 days in combined treatment group and 119 days in solitary stent insertion group(P<0.01);the median survival time was 209 days in combined treatment group and 145 days in solitary stent insertion group,the differences were significant(P<0.01).Based on the univariate and multivariate Cox regression analyses,the predictors of prolonging survival included subsequent HIFU ablation after stent insertion and earlier tumor stage(P<0.05).Conclusion Combined biliary stent insertion and HIFU ablation is a safe and effective method for malignant obstructive jaundice caused by pancreatic carcinoma,and seems to extend stent patency time and survival when compared with biliary stent only.

Objective To study the effect of sodium hyaluronate on the expression of transforming growth factor-β3(TGF-β3) and Smad 6 of the epidural scar tissue. Method Totally 60 male SD rats were randomly divided into two groups:the control group(A, n = 30), sodium hyaluronate group(B, n = 30). 0.25 × 1 cm2 dura mater uncovered area laminectomy was performed at L4 and L5, covered with 0.3 ml sodium hyaluronate in group B, covered with same amount of saline in group A. The animals were sacrificed at 2, 4 and 8 weeks after operation. The specimens were prepared for determination of the expression of TGF-β3 and Smad 6 at scar tissue and the degree of scar adhesion according to Rydell method, and observed the ultrastructure changes of scar tissue with transmission electron microscope. Results At 2 weeks after operation, the expression of TGF-β3 mRNA of two groups were 0.22 and 0.257 ( P = 0.027), respectively. At 4 weeks, group B was was increased significantly, and the mean numbers were 0.362 and 0.411 (P = 0.006). At 8 weeks, the expression of TGF-β3 mRNA of group A was increased significantly, too, but the difference between two groups was significantly, they were 0.427 and 0.470 (P =0.015), respectively. The trend of the expression of TGF-β3 and Smad 6 mRNA was similar. At 2, 4, 8, weeks, the expression was 0.169 and 0.205 (P = 0.089), 0.294 and 0.351 (P = 0.031), and 0.469 and 0.543 (P = 0.021), respectively.In group B the duramater adhesion was decreased (P ＜ 0.05), the proliferation of fibroblasts and fihroblastic function were inhibited (P ＜ 0.05). Conclusions Sodium hyaluronate up-regulated the expression of TGF-β3 and Smad6 and reduced the proliferation and collagen synthesis in fibroblast culture in the scar tissue.

OBJECTIVE To study the risk factors of extended-spectrum beta-lactamases(ESBLs) producing bacteria infection in children,and provide reference to prevent and control the prevalence of bacterial strain of ESBLs.METHODS In a case and control studys the samples were selected randomly from 2007 to 2009 in the Children′s Hospital of Shanxi Province.The samples of case and control were all 100.RESULTS ?2 Test showed that boy and baby,previous history,pneumonia,medical ward,hospital infection and using antibiotics before admission to hospital were the risk factors;t-test showed that high white blood cell and neutrophil were the protective factors;Logistic regression showed that boy,previous history,hospital infection,using antibiotics before admission to hospital and medical ward were the risk factors and anal tube was a protective factor.CONCLUSIONS Increasing the rate of bacteriological test to the children who have the relative risk factors is very important to prevent and control the prevalence of ESBLs strain.

Objective To test and verify the performance of analyzing IgG using nephelometry assay,and discuss reasonable model of performance verification of this system.Methods According to related documents and standards,this study verified the precision,accuracy,assay measurement range(AMR)and reference interval.Results The within-run precision in low level was 2.24%,while it was 2.73% in high level.The overall precision in low level was 2.25%,while it was 2.68%.The relative bias between the results of analyzing the calibrator with a different lot from that used for calibrating and its concen-tration printed was 5.18%.The AMR of the original dilution was 2.44~33.5 g/L.The results of reference interval verifica-tion identified with what the manufactur declares.Conclusion The major performances of analyzing IgG by this system are identifies with the manufactur declares.The reference interval offered by the manufactur is acceptable.The verification and calculation methods are simple and convenient,with strong operability.

Objective To investigate the risk factors for poor response to treatment in juvenile-onset systemic lupus erythematosus (SLE).Methods The clinical manifestations,treatment and follow up data of the initial onset SLE patients in our hospital were collected retrospectively.According to the response to treatment after 6 months,patients were divided in two groups.One was treatment effective group,and the other was poor response group.The data of the two groups were analyzed by SPSS 16.0 Counted data were analyzed by Chi-square test.Measurement data were analyzed by t-test.The areas under ROC curve of the measurement data which had statistical significance were calculated and further Logistic regression analysis were made.Results In all of the 82 patients with first onset SLE,72 patients were in the treatment effective group and 10 were in the poor response group.Boy gender (5/10 & 12/72,x2=5.937,P=0.015),edema (10/10 & 25/72,x2=15.294,P＜0.O1) and serositis (8/10 & 25/72,x2=7.485,P=0.006),higher positive rate of Coombs' test (7/8 & 14/29,x2=3.931,P=0.047) and histological class Ⅳ or Ⅳ+Ⅴ of lupus nephritis (8/9 & 6/30,x2=14.278,P＜0.01) were more common in the poor response group.The level of hemoglobin (P=0.013),serum albumin (P=0.001) and globulin (P=0.004),creatinine clearance (P＜0.01),serum calcium (P=0.040) and immunoglobulin (P=0.006) of the patients in the poor efficacy group were lower than those of patients in the treatment effective group.The level of serum potassium (P=0.011),serum phosphorus (P=0.035),24 hours proteinuria (P=0.001) and SLEDAI (P=0.002) of the patients in the poor response were higher than those patients in the treatment effective group.The creatinine clearance was lower than 75.91 ml·min-1· 1.73 m-2,24 hours proteinuria was higher than 1 771.5 mg and SLEDAI was higher than 11.5 could be the diagnostic cutoff value to predict the poor response to treatment in juvenile-onset SLE patients.The results of Logistic regression analysis showed creatinine clearance lower than 75.91 ml ·min-1· 1.73 m-2 was the risk factor that could influence the outcome of SLE patients (P=0.043).The OR was 23.9 and 95％CI was from 1.10 to 516.8.Conclusion In juvenile-onset SLE patients,boys have poor response to treatment.The creatinine clearance lower than 75.91 ml·min 1· 1.73 m-2,24 hours proteinuria higher than 1 771.5 mg and SLEDAI higher than 11.5 can predict the poor response to treatment in juvenile-onset SLE patients.In addition,the SLE patients with autoimmune hemolytic anemia may have poor response to treatment.

Objective To study the role of urinary kidney injury molecule-1 (KIM-1) in pediatric Henoch-Sch?nlein purpura (HSP). Methods Urinary levels of KIM-1 were examined using ELISA in 48 children with HSP including 23 HSPN children (HSPN group) and 25 non-HSPN children (HSP group), and 20 healthy children. The levels of urinary creatinine and 24-hour urine protein were also detected. The results were analyzed and compared among groups. Results The ratio of urinary KIM-1/creatinine (Cr) in HSPN children was signiifcantly higher than that in the other two groups (P<0.05). There was no signiifcant difference in the ratio of urinary KIM-1/Cr between HSP group and the control group (P>0.05). The ratio of urinary KIM-1/Cr had no correlation with 24-hour urine protein in all HSP children (r=0.239, P=0.590). Conclusions Urinary KIM-1 may play a role in the pathogenesis of pediatric HSPN.

Objective To observe the expression of cell proliferation and apoptosis in congenital pulmonary cyst and to investigate their effect in the development of aspergillus.Methods Immunohistochemical method was used to detect the expression of KI-67、BCL-2 and BAX in normal lung tissue from 10 adult(control group 1,CG1),relative normal lung tissue around the aspergillus from 20 aspergillus cases(control group 2,CG2)and abnormal lung tissue from 20 aspergillus cases.Results The expressions of KI-67,BAX and the ratio of BAX/BCL-2 in the bronchial epithelium of aspergillus were significantly higher than those in two control groups(P

Objectiive:The present study was designed to explore whether overexpression of human wild ?-synuclein in rat brain caused selective dopaminergic neuron loss in substantia nigra and aimed to find out a new method to make a rat model of Parkinson's disease(PD).Methods:The human wild ?-synuclein gene was induced into the rat brain by Adeno-Associated Virus(AAV) vector.The overexpression of ?-synuclein was detected by realtime PCR.The behavior of rats were recorded every 4 weeks after the viral particle injection.TH immunohistochemistry were performed at 4,8,12 and 16 weeks post-injection as well as the dopamine(DA),3,4-dihydroxypheny-lacetic acid(DOPAC) of striatum were determined by high performance liquid chromatography coupled with electrochemical detection.Results:Realtime PCR results revealed a significant overexpression of ?-synuclein in the injected hemisphere.By 8 weeks post injection,a significant loss of the dopaminergic neurons was observed.34% of the dopaminergic neurons were lost after 12 weeks,and about 60% cells loss after 16 weeks.The DA and DOPAC levels in the striatum decreased about 15% 12 weeks after injecting viral particle carried ?-synuclein gene and 30% decreased after 16 weeks.The AAV-?-synuclein-treated rats developed a type of motor impairment,i.e.,head position bias,compatible with this magnitude of nigrostriatal damage.Conclusion:All the results showed that overexpression of human wild ?-synuclein caused selective dopaminergic neuron loss and mimic a symptom of human PD in rats.This may be a new methed to make rat PD model which can offer new opportunities for the study of pathogenetic mechanismsand exploration of new therapeutic targets of particular relevance to human PD.

Objective To analyse the characteristics of fundus fluorescein angiography(FFA)of iatrogenic retinal vascular occlu- sion.Design Retrospective case series.Participants 9 eyes of 9 patients with iatrogenic retinal vascular occlusion and 16 eyes of 16 patients with non-iatrogenic retinal vascular occlusion in Beijing Tongren Hospital in 2002-2005.Methods All patients were examined with FFA.The difference of circulation time of retinal vessels both in iatrogenic and non-iatrogenic retinal vascular occlusion patients was compared.Main Outcome Measures The starting perfusion time and the finishing time of retinal artery or vein.Results In pa- tients with iatrogenic(4 cases)and non-iatrogenic(12 cases)central retinal artery occlusion,the finishing perfusion time was separately 79.33?87.04s and 19.20?4.61s; the finishing time of retinal vein was separately 128.07?149.11s and 33.16?15.34s.In iatrogenic(4 cas- es)and non-iatrogenic(4 cases)central retinal artery together with central retinal vein occlusion patients,the finishing perfusion time of retinal artery was separately 211.67?371.26s and 30.07?17.26s;the finishing perfusion time of retinal vein was 232.43?358.52s and 48. 81?11.64s.One patient was ocular artery occlusion.FFA showed that choroidal background fluorescence and central artery were perfused slowly,the vascular fluorescence perfusion was interrupted before it came out of optic disk and the perfusion interruption continued until late stage with extensive peripheral non-perfusion areas.Conclusion The perfusion time of the retinal artery and vein in iatrogenic reti- nal vascular occlusion may be much longer than that in non-iatrogenic retinal vascular occlusion.