Objectives To investigate the clinical features of Guillain-Barré syndrome (GBS) in children from Shen-zhen. Methods The clinical manifestations, results of electrophysiological tests and prognosis of 28 GBS patients from July 2002 to July 2012 were retrospectively analysed. Results Of 28 children, 16(57.1%) had preceding acute upper respiratory infection for 3-14 days but no patient had acute gastroenteritis. One had received HBV vaccination in 2 weeks before the onset of GBS. The peak season for GBS is spring. According to the clinical presentations and the neurophysiological results 17 patients had demyelinating neuropathy, 5 acute motor axonal neuropathy, 2 acute motor sensory axonal neuropathy, 3 Miller-fisher syndrome, and 1 polyneuritis cranialis. 14 (50.0%) patients suffered from pain in limbs which is the most nota-ble symptom in the early stage. Intravenous immune globulin (IVIG) and steroids were given during the acute phases in the majority of the patients, and assisted ventilation was performed in 2 patients due to respiratory muscle paralysis. No diffe-rence was found in Hughes scores, average hospitalization durations, and the prognosis between patients with GBS variants patients and patients with classic GBS. Conclusions Children with GBS in Shenzhen area have different clinical features.

Objective To observe the effects of acute normovolemic hemodilution(ANH) plus tranexamic acid on blood loss and blood transfusion in patients with total knee replacement.Methods 98 cases of patients with total knee replacement were divided into ANH group and combination group by computer randomization,49 cases in each group.ANH was performed in ANH group,and ANH plus tranexamic acid was given in combination group.The changes of hemoglobin(Hb),red blood cells deposited(Hct),platelet count(PLT) were observed before and after autologous blood transfusion in two group.The changes of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer were observed at preoperative and postoperative in two group.The amount of blood loss and allogeneic blood infusion,the urine volume and the postoperative flow volume were recorded in two groups.Results The average levels of Hb,Hct after autologous blood transfusion in combination group were higher than those in ANH group,the differences were statistically significant(P<0.05).The average level of D-dimer at postoperative in combination group were higher than that in ANH group,the difference was statistically significant(P<0.05).The amounts of blood loss and allogeneic blood infusion,the postoperative flow volume were lower than those in ANH group,the differences were statistically significant(P<0.05).Conclusion The joint application of ANH and tranexamic acid can effectively reduce the amounts of blood loss and allogeneic blood infusion in patients with total knee replacement,and has a certain clinical value.

Objective To investigate the methods of diagnosis and treatment of pediatric and hebetic adrenocorticotropic hormone ( ACTH) secreting pituitary microadenoma. Methods The data of 10 patients with ACTH secreting pituitary microadenoma were retrospectively analysed. ACTH secreting pituitary microadenoma was diagnosed by clinical manifestations, biochemical and imaging findings, and 5 patients underwent bilateral inferior petrosal sinus sampling ( BIPSS). Transsphenoidal surgery was performed on all the patients under microscope, and the tumor specimens were detected by immunohistochemistry. Results Immunohistochemical examination revealed that ACTH was positive in 8 cases and negative in 2 cases. Patients were followed up for 12 to 63 months, 7 cases (70%) were cured, one (10%) achieved remission, and the other two (20%) experienced recurrence. Conclusion BIPSS is helpful in the diagnosis and localization of pediatric and hebetic ACTH pituitary microadenoma, and transsphenoidal surgery is the optimal choice of treatment.

Objective To explore the relationship between plasma ghrelin levels and glucose and lipid metabolisms of child and adolescent obesity.Methods 30 cases of obesity and 30 healthy normal weisht children and adolescents with same age and gender were selected.Plasma ghrelin level,serum insulin(INS),C-peptide(CPE),fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),high-density lipoproteins(HDL),low-density lipoproteins(LDL)were measured.Results For the obesity group:Plasma ghrelin level significantly decreased [(15.49±1.98)vs(19.47 ±1.50)μg/L]compared with control(P＜0.05);BMI,waistline,FBG,INS were very significantly increased(28.19±3.83)vs(21.07±1.53)kg/m2;(88.60±6.13)vs(78.52 ±4.40)cm;(5.23±0.49)vs(4.59 ±0.63)mmol/L;(22.32 ±3.50)vs(16.98±2.50)μIU/ml,respectively compared with control(all P＜0.01);TC was significantly increased(5.87±0.88)vs(4.05±0.76)nmol/L compared with control(P＜0.05).For the plasma ghrelin level of obesity:The relationship between plasma ghrelin level and body weight,BMI,waistline,INS,TC was obviously negative(r=-0.385,-0.466,-0.336,-0.387,-0.373,respectively,all P＜0.01);The relationship between plasma ghrelin level and FBG was obviously negative(r=-0.324,P＜0.05);No relationship between plasma ghrelin level and age,body height,CPE,TG,HDLC,LDLC.Conclusion Plasma ghrelin level of children and adolescent obesity was obviously decreased,and was strongly related with disordem of glucose and lipid metabolisms.

Objective To study the influence of PYLL on life span of residents. Methods The reduce of potential life span in Kunshan residents from 1982～1999 was analysed between the male and female. Results The life span reduced significantly in injury, poisoning and c ancer, which accounted for over 56% of total causes o f death in PYLL, especially, over 60 % in male. PYLL rate in male was higher than that in female. PYLL rate in male a nd female (except brain blood vessel disease) from 1991～1999 was lower than tha t from 1982～1990. It was consistent with increasing of old age population pr oport ion and prolonging of expected life span in Kunshan residents year by year. Conclusions The reasons that causes to death of residents were injury a nd poisoning and cancer.

Objective To study the distribution status and clinical significance of human papillomavirus(HPV) infection geno‐types in condyloma acuminate(CA) tissues of vulva ,vagina and cervix .Methods The gene‐chips combined with polymerase chain reaction (PCR) technology were utilized for detecting 23 kinds of HPV genotypes in tissue specimens from 63 cases of vulval CA , 61 cases of vaginal CA and 65 cases of cervical CA .Their clinical pathological data were analyzed .Results In 63 cases of vulval CA ,56 cases were HPV positive with the HPV infection rate of 88 .89% (56/63) ,in 61 cases of vaginal CA ,55 cases were HPV positive with the HPV infection rate of 90 .16% (55/61) ,and in 65 cases of cervical CA ,62 cases were HPV positive with the HPV infection rate of 95 .39% (62/65) .Conclusion HPV infection is closely related to the CA pathgenesis in vulva ,vagina and cervix . HPV6 and HPV 11 are main stream genotypes ,in which vulval CA is most common .The gene‐chips combined with PCR technology is a method suitable for HPV typing diagnosis ,and has the characteristics of good sensitivity and high specificity ,which has an im‐portant significance for clinical diagnosis ,treatment and vaccine study of CA in femal vulva ,vagina and cervix .

Objective To compare the sensitivity of fluorescent quantitation polymerase chain reaction (fluorescent quantitation method) and gene‐chips typing method(gene‐chips method) in the detection of human papillomavirus(HPV) ,and to analyse differ‐ences and clinical significance .Methods A total of 246 women were selected as subjects ,among them ,111 cases of cervical exfolia‐ted cells and 135 cases of cervical tissues were collected and detected .15 kinds of high‐risk HPV genetypes were detected in all sub‐jects by using fluorescent quantitation method and gene‐chips method respectively ,and the detection results were compared . Results The sensitivity of the fluorescent quantitation method in detecting HPV was 55 .28% and that of the gene‐chips method was 55 .69% ,there was no statistically significant difference in sensitivity between the two methods (P>0 .05) .The two methods had relative high conformance(κ=0 .745) .The positive rate of HPV infection was increased with the progression of cervical dis‐ease .Conclusion The fluorescent quantitation method and the gene‐chips method have a relative high conformance ,and both with high sensitivity in detecting HPV .The severity degree of cervical cytological and histological changes may be positively correlated with HPV infection .

Objective To understand the level of urinary iodine of schoolchildren and salt iodine content of their families in a primary school and to analysis influence between salt iodine content and urinary iodine level in Haimen City,Jiangsu Province.Methods A cross-sectional study was conducted in a primary school of Haimen City in 2012.With the method of stratified cluster sampling,all students aged 9 ～ 12 were extracted in grades 3-5,urine samples and salt samples of their family were collected.Urinary iodine and salt iodine were determined according to Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry (WS/T 107-2006) and Direct Titration of Universal Test method in Salt Industry (GB/T 13025.7-1999).Results Totally,452 students from grades 3-5,including 233 boys and 219 girls were selected by cluster-stratified sampling.The median of children's urinary iodine was 231.90 μg/L,while the median of boys and girls was 235.40 and 222.60 μg/L,respectively.The median of urinary iodine of 9,10,11 and 12 year old students was 253.65,195.70,236.40 and 241.70 μg/L,respectively.The proportion of less than 100 μg/L and ≥300 μg/L was 7.7％ (35/452) and 27.7％ (125/452),respectively.There were no significant differences between different gender and age students.Among the 452 salt samples collected the median of salt iodine was 27.50 mg/kg.The coverage rate of iodized salt,the qualified rate of iodized salt and the intake rate of qualified iodized salt were 98.9％ (447/452),95.1％ (425/447) and 94.0％ (425/452),respectively.After consumptionn of non-iodized salt (＜ 5 mg/kg),unqualified iodized salt(5 ～ ＜ 20 mg/kg or ＞ 50 mg/kg) or qualified iodized salt [(35 ± 15)mg/kg],the median of urinary iodine of children was 177.30,211.95 and 232.90 μg/L,respectively.Correlation analysis showed that there was no relationship between iodine content of salt and urinary iodine level of schoolchildren (r =0.085,P ＞ 0.05).Conclusions Current nutritional level of schoolchildren in Haimen City is higher than the appropriate amount.Household salt iodine content of edible salt does not affect urinary iodine level of the children significantly.

Objective: To investigate the relationship between C-reactive protein(CRP)and its-717MG polymorphismin atrial fibrillation(AD of the population of the city of Nantong.Methods:The relationships between AF and AF risk factors were analyzed by comparing genders,ages and body nlagS index(BWI)in 92 AF patients and 60 non-AF control subjects.The serum CRP levels were detected by immunoturbidimetry in of the two groups.The CRP-717MG polymorphism wa8 detected by polymerage chain reaction-restriction fragment-length polymorphism in patients and control subjects.Results:The sel3utm CRP level wag positively correlated with the left atrium internal diameter(LAD)in AF patient group(r=0.58,P＜0.01).The level of CRP Wag significantly higher in AF patient group compared with that of control group(P＜0.01).The serum CRP level Wag higher in patients with non-paroxysmal atrial fibrillation than that of patients with paroxysmal atrial fibrillation(P＜0.05).There Wag no significant difference in the frequency of CRP genotype between AF and control groups(P＞0.05).But the alleles frequency of the G Wag lower in AF group than that of control group(P＜0.05).Conclusion:The semm CRP level is associated with AF and its subgroups.The serum CRP level is positively correlated with LAD.The results suggest that the inflammation influences the AF though atrium reconstruction.The relationship between CRP-7 17A/G and AF stir needs further large-scale perspective studies.

Objective For developing safe and effective anti-radiation new drugs,the effects of different lipoic acid amino acid salts on radiosensitivity were investigated.Methods The free radical scavenging ability of the above salts was evaluated in Fenton system.CCK-8 assay and flow cytometry assay were performed to evaluate the survival rate of L02 and apoptosis of AHH-1 after γ-ray irradiation,respectively.Results The lipoic acid arginine salt had the best ability of scavenging free radicals in Fenton system with an IC50 of 8.40 μ moL/ml.The survival assay showed that lipoic acid amino acid salts had better stability and equal ability in radioprotection (P ＞ 0.05) compared with lipoic acid.The apoptosis assay indicated that all lipoic acid amino acid salts could inhibit radiation-induced apoptosis,where lipoic acid arginine salt was more effective (t =-6.67,P ＜ 0.01).Conclusions Lipoic acid arginine salt has good radioprotection effect on L02 and AHH-1 cells by scavenging free radicals.