ObjectiveTo search clinical operational threshold of neonatal hypoglycemia.Methods From Jan 2007 to Jan 2009,128 neonates in our hospital were divided into 4 groups:normal control group (blood glucose range 3.30 ～ 6.10 mmol/L during hospitalization) ;treatment I group (blood glucose range 2.60 ～ 3.29 mmol/L keep 2 h,maintain normal range after 4 h) ; treatment Ⅱ group ( blood glucose range 2.20 ～ 2.59 mmol/L keep 2 h,maintain normal range after 4 h ) ;treatment Ⅲ group(blood glucose ＜2.20 mmol/L keep 2 h,maintain normal range after 3 h).Relevant data of the latency of main waves on the neonates were collected and analyzed by flash visual evoked potential( F-VEP) test.ResultsThe main waves of F-VEP in all the 128 neonates were existed.The latency of main waves in group Ⅱ [ (212.9 ± 18.9) ms] and group Ⅲ [ (223.1 ±20.4) ms] were significantly longer than that in the normal control group [ ( 199.2 ± 14.3) ms] respectively (P ＜0.01 ),and the latency of main wavesin group Ⅲ were longer than that in group Ⅱ ( P ＜0.01 ).There were no significant difference in group I [ (203.3 ± 15.4) ms ] as compared with the other groups (P ＞ 0.05 ).When blood glucose of the treatment group maintain on 3.30 ～ 6.10 mmol/L,the latency of main waves of F-VEP in group Ⅱ and group Ⅲ [ (202.9 ± 15.2) ms,(203.1 ± 15.5) ms ] had no differences as compared with the control group[ ( 199.2 ± 14.3 ) ms ] (P ＞ 0.05 ).ConclusionIt may be appropriate that the threshold of blood glucose for diagnostic criteria of neonatal hypoglycemia is less than 2.60 mmol/L rather than 2.20 mmol/L,whether the neonates have any clinical manifestations or not.

Objective To investigate the clinical characteristics of purulent meningitis caused by streptococcus pneumoniae.Methods We studied clinical features of 12 children with purulent meningitis caused by streptococcus pneumoniae who were hospitalized from Jan 2007 to Oct 2011 in our hospital.Results Twelve children were penicillin-resistant streptococcus pneumoniae.The ages ranged from 2 months to 10 years.Nine cases(75％) were aged less than 5 years,and 5 cases(41.6％) were aged less than 2 years.All cases were with fever,and with the nervous system symptoms involvement.All cases were with complications:9 cases(75％) with septicemia,8 cases (66.7％) with pneumonia.The white blood cells,blood C-reactive protein,peripheral blood procalcitonin,erythrocyte sedimentation rate,white cells and protein in cerebrospinal fluid were mostly significantly high,sugar in cerebrospinal fluid were low significantly.Eleven cases were eventually treatmented by vancomycin plus 3rd to 4rd generations of cephalosporins antibiotics or other antibiotics.Eight cases were cured,2 cases with serious sequela,and 2 cases died.Conclusion We should attach importance to the meningitis caused by streptococcus pneumoniae.For clinical suspects pneumonia streptococcus meningitis,to given the powerful therapy by vancomycin plus the other antibiotics,as early as possible.

Objective:To investigate the effect of transforming growth factor (TGF- β) signal in muscle fiber itself during inflammation/immunity response on intramuscular inflammation. Methods:Sixteen wild C57BL/6 mice (wild group) and sixteen mice with skeletal muscle-specific deficiency of T βRⅡ (knock-out group) between 4-8 weeks of age were selected for this study. Acute muscle injury in mice was induced by injection of myotoxin cardiotoxin (CTX) into gastrocnemius. The differences in intramuscular inflammation were compared between the wild and knock-out groups on 0, 4, 7 and 10 d after CTX injection by observing exudation of mononuclear phagocytes, macrophages, M1 type macrophages, CD4 +T cells and helpers T cells (Th1, 2&17). Two newborn C57BL/6 wild mice and 2 SM TGF- βr2-/- knock-out mice were selected to culture primary myoblasts in vitro which were divided into 2 groups: an interferon group subjected to interferon simulation and a control group subjected to addition of an equal amount of solvent. The differences in expression of IL-6, IL-10, MCP-1, MIP-1α, H-2K b, H2-Ea, Toll-like receptor (TLR)3 and TLR7 were compared between the interferon and control groups, as well as between the wild and knock-out groups. Results:On 4&7 d after CTX injection, the ratios of mononuclear/macrophage (75.73%±3.62%, 45.27%± 2.32%), macrophages (38.67%±2.76%, 24.87%±2.19%), M1 macrophages (43.21%±0.11%, 30.43%±2.19%), CD4 +T cells (20.13%±1.62%, 5.67%±0.32%) in the muscle tissue from the knock-out mice were significantly higher than those from the wild mice (58.52%±2.43%, 29.21%±2.45%; 20.63%±2.32%, 16.23%±1.25%; 24.98%±0.35%, 14.23%±1.69%; 10.70%±0.43%, 2.50%±0.45%), with a majority of Th1&Th17 ( P<0.05). In vitro results showed that the levels of IL-6, MCP-1, MIP-1α, H-2K b, H2-Ea and TLR3 were significantly upregulated in the interferon group compared with the control group and that such upregulation in the nock-out mice was more significant than in the wild mice ( P<0.05). Conclusions:Endogenous TGF- β signal activation plays a role in the functional recovery after muscle trauma, because it is involved in the regulation of immune behavior of muscle fibers, thus affecting intramuscular inflammation and muscle regeneration.

Objective To detect the disparity of three biological molecules Caveolin-1,IL-1β,VEGF in cerebrospinal fluid of children with viral encephalitis at the different stages; to explore the role of Caveolin-1,IL-1β,VEGF in the pathogenesis of viral encephalitis;and to evaluate their clinical significance in assessing the severity and prognosis of viral encephalitis.Methods We recruited 65 inpatients children with viral encephalitis in the Second Neurology Department of Hunan Children's Hospital from July 2011 to July 2012.Subjects were divided into 2 groups:54 cases of acute phase and 11 cases of recovery phase.According to the clinical manifestations,they were re-divided into 40 patients with mild viral encephalitis and 25 cases of severe viral encephalitis.Twenty healthy age matched controls (10 cases of epilepsy and 10 cases of congenital abnormality) were also taken for the study.Cerebrospinal fluid exam,EEG,head MRI and other tests were performed in all patients.Caveolin-1,IL-1β and VEGF levels in cerebrospinal fluid of 65 children with viral encephalitis and 20 age-matched controls were measured using ELISA.Results Cerebrospinal fluid Caveolin-1,IL-1β,VEGF levels in the acute phase of viral encephalitis were (49.209 ± 22.320) pg/ml,(16.923 ± 6.823) ng/ml,(44.342 ± 19.264) ng/ml respectively,and (33.253 ± 20.349)pg/ml,(11.724 ± 3.009)ng/ml,(30.312 ± 18.147) ng/ml in recovery phase,which were significantly higher than those of controls (P ＜0.01).The difference was statistically significant between acute phase and recovery phase (P ＜ 0.05).Acute viral encephalitis patients had higher Caveolin-l,IL-1β,VEGF levels than the epilepsy group,and the difference was statistically significant (P ＜ 0.05).In viral encephalitis group,children with cerebrospinal fluid protein content (0.5 ～ 1.0 g / L) had higher of Caveolin-1,IL-1β and VEGF levels as compared with those with cerebrospinal fluid protein content ≤ 0.5 g/L,and the difference was statistically significant (P ＜ 0.01).Cerebrospinal fluid Caveolin-1,IL-1 β and VEGF showed no significant difference among children with different severity of encephalitis,different levels of frequent seizures,different degrees EEG changes (P ＞ 0.05).But in the patients with severe head MRI changes,cerebrospinal fluid Caveolin-1,IL-1β,VEGF levels increased significantly (P ＜ 0.05).Conclusions Caveolin-1,IL-1β and VEGF may participate in the pathogenesis of viral encephalitis.Detection of these parameters may be helpful to the evaluation of the severity and prognosis of viral encephalitis.

Objective To investigate the factors associated with seizure relapse after antiepilepsy drug (AED) withdrawal in childhood epilepsy.Methods A retrospective analysis was conducted in epileptic children of Hunan Children's Hospital from Jan.2003 to Jan.2011.Among those with anti-epileptic therapy for seizure-free period over 2 years,the patients who relapsed after withdrawal were followed up through outpatient clinic visits and/or by telephone interviews for at least 2 years.Results Of the 127 cases of children enrolled in this study,28 patients(22.05％) relapsed [male:12/59 cases (20.34％) and female:16/68 cases (23.53％)].Cumulative relapse rates were 18.18％ (8/44 cases) in infancy,15.79％ (6/38 cases) in toddlers,23.53％ (8/34 cases) in preschool children,and 54.55％ (6/11 cases)in school age group.Of the patients who relapsed,generalized seizure occurred in 12/87 cases (13.79％),partial seizure in 16/40 cases(40.00％).According to seizure frequency between the first seizure and AED administration,3 cases(6.25％) relapsed among 48 cases of seizure frequency ＜ 5 times,13 cases(24.07％) relapsed among 54 cases of seizure frequency 5 to 10 times,and 12 cases(48.00％) relapsed among 25 cases of seizure frequency more than 10 times.Relapse occurred in 9 cases of monotherapy(9/91 cases,9.89％) and in 19 cases of polytherapy (19/36 cases,52.78％).According to the seizure control period (period between the beginning of antiepileptic treatment and AED withdrawal),14 cases relapsed among 37 cases with the seizure control period of 2 to 3 years (37.84％),8 cases relapsed among 51 cases with the period of 3 to 4 years (15.69％),and 6 cases relapsed among 39 cases with the period of 4 to 5 years(15.38％).According to AED tapering off period,10 cases relapsed among 24 cases with the period of 3 months (41.67％),9 cases relapsed among 36 cases with the period of 3-6 mc ths (25.00％),and 9 cases relapsed among 67 cases with the period of over 6 months(13.43％).Factors associated with an increased risk of relapse were age of epilepsy onset,seizure type,route of administration,timing of antiepileptic trug withdrawal,tapering speed,which were had statistical significance (x =8.051,6.780,16.896,27.607,7.576,8.451,all P ＜0.05).Gender difference was not associated with the risk of relapse(x2 =0.187,P ＞ 0.05).Conclusions Factors associated with an increased risk of relapse are age of epilepsy onset,seizure type,route of administration,timing of antiepileptic drug withdrawal,tapering speed.Standard therapies of early treatment,adherence to medication for at least 3 years,taper period for more than 6 months are associated with a decreased probability for relapse.

Objective To investigate the cause of blindness and low vision of students in Guangzhou Blind School.Methods The 254 students in Guangzhou Blind School were examined with international standard visual acuity chart,including naked visual acuity and corrected visual acuity.The student's inner,outer eyes were also examined in order to find the cause of blindness and low vision.Results In the 254 students,222 suffered from blindness(87.4%),and 32 suffered from low vision(12.6%).The leading cause of blindness was retinopathy of prematurity(ROP)(32.88%).The leading cause of low vision was congenital,heritage oculopathy,especially the congenital cataract(31.25%).Conclusion ROP is the leading cause of blindness of students in Guangzhou Blind School.

Objective To analyze the constituent of the 32 kD protein band and its expression in schizophrenia se?rum. Methods Sixty schizophrenia patients and 58 health controls were recruited. The serum samples were collected and precipitated with 7%PEG. The sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) was used to ob?tain the abnormal 32 kD proteins band in patients. This protein band was cut and then analyzed using mass spectrometric technique. Results The 32 kD protein band was present in 38 schizophrenia patients but not in control and positive rate was 63.33%. The mass spectrometric analysis showed that 32 kD protein band contained 14 proteins ranging from 30 kD to 35 kD, including 6 high-frequency proteins (cDNA coded protein 1 and 2, Apolin protein A-1, Isoform 2 of ficolin-2, Complement factor H and clusterin) and 8 low-frequency proteins (IgG H chain, zinc-alphg-2-glycoprotein, fermitin,family apolin protein L-1, isoform 10 of collectin-1, purine nucleoside, anne xin and cDNA coded protein 3). Three cD?NA coded unknown proteins were highly similar to complement C4-B, β2-glycoprotein and erythrocyte band 7 integral membrane protein. Conclusion There is a unknown specific 32 kD protein that is consisted mainly of fourteen proteins in serum of schizophrenia.

Objective:To explore the relationship of anxiety,perceived stress and forbearance in the college students.Methods:Totally 3 056 college students(1 102 males and 1 954 females)in Guangdong Province were re-cruited and assessed with the Generalized Anxiety Disorder 7-item Scale(GAD-7 score of ≥10 indicates positive anxiety symptoms),Perceived Stress Scale(PSS-10),and Forbearance Scale(FS).SPSS Process model 2 was used to test the moderating effect of different types of forbearance.Results:Totally 486(15.9％)college students had anxiety.The PSS-10 scores were positively correlated with the GAD-7 scores(β=0.63),and FS scores of repres-sive forbearance and active forbearance played a moderating role between the PSS-10 scores and the GAD-7 scores respectively(β=0.05,-0.04).Conclusion:It suggests that anxiety and perceived stress are correlated with for-bearance in college students,and repressive forbearance and active forbearance may moderate the relationship be-tween perceived stress and anxiety.

Objective:To explore the appropriate time of intravenous immunoglobulin(IVIG)in standard initial treatment of Kawasaki disease in children.Methods:To consult the data of children with Kawasaki disease admitted to Department of Pediatrics,Sanming First Hospital Affiliated to Fujian Medical University from January 2016 to March 2021.A total of 163 eligible cases were re-trieved during the study period,of which 53 cases in early group were treated with initial IVIG 1～4 days after onset;initial IVIG treat-ment time was 5～7 days after onset in medium-term group,with a total of 54 cases;initial IVIG treatment time was 8～10 days after on-set in late group,with a total of 56 cases.Immune function,biological markers,echocardiography,initial IVIG non-response,hospi-talization days and main clinical manifestations after treatment were compared.Results:After treatment,levels of lymphocyte subsets in three groups were improved,among which the levels of CD4+T,CD4+T/CD8+T and CD19+T were decreased,while levels of CD3+T,CD8+T and NK were increased.Levels of biological markers were lower than those before treatment;there were significant differences in levels of lymphocyte subsets,biological markers,incidence of IVIG inactive Kawasaki disease,incidence of coronary artery lesion and coronary aneurysm among the three groups after treatment(P<0.05).The differences between the early group and the medium-term group and the late group were statistically significant(P<0.05).There was no significant difference between the medium-term group and the late group(P>0.05);and the early group had the best major clinical manifestations and the shortest hospital stay.Conclu-sion:In standard initial treatment of Kawasaki disease in children,the use of IVIG within 5 days after onset of immune function recov-ery is the best,reduce level of inflammation and protein markers is the best,but also can quickly improve clinical symptoms,shorten the length of hospital stay,and has the lowest incidence of IVIG no-response to Kawasaki disease,minimal coronary artery disease and coronary aneurysm complications,may be suitable for use.

Objective CRISPR/Cas9 genome-editing technique provides an novel method for whole genome editing in eukaryotic cells.Recently,we found that gene subtype library with smaller size and focused pur-pose is more economical and practical. In this study,we aimed to target kinases,a group of pivotal cell signal transducers,to construct a kinase knock-out library using CRISPR/Cas9 technique.The construction strategy wll al-so be discussed. Methods 10 sgRNA was designed for each kinase target.After oligo pool synthesis by semicon-ductor chip,the oligos were eluted from the chip. The oligo templates were amplified and cloned into Cas9 vector and transformed into Stble3 competent cells.Monoclonal colonies were selected for DNA sequencing. Results(1) GO analysis of 507 cell kinases showed that the cell kinases took part in a wide range of cell signaling.(2)The sgRNA pool with about 140 bp in length was successfully amplified by using oligo pool as the template and univer-sal PCR primers.(3)In 40 identified library clones,34 clones were sequenced successfully. Among them,the DNA sequencing results of 25 samples were completely consistent with the designed target sequences.But there are some mutations in the primers of 9 samples.Failure in bacteria shaking,DNA sequencing and other factors were ex-isted in the other clones. Conclusion The CRISPR/Cas9 kinase knock-out library can be widely used for screen-ing the important kinases which may mediate cell proliferation,metastasis,drug resistance and autophagy.This li-brary will play an important role in clarifying the development of disease associated with kinases.