Adolescent ; Basal Ganglia ; pathology ; Calcinosis ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Risk Factors ; Stroke ; etiology ; Wounds and Injuries

Adult ; Female ; Humans ; Laryngeal Diseases ; microbiology ; Male ; Middle Aged ; Pharyngeal Diseases ; microbiology ; Pharyngitis ; microbiology ; Syphilis ; Treponema pallidum

Forearm ; innervation ; Ganglion Cysts ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; innervation ; surgery ; Tendons ; surgery ; Ulnar Nerve ; surgery

In November 2018,the American Heart Association(AHA) updated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The new guideline provided the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. The update was carried out by the Pediatrics Working Group of the International Liaison Committee on Resuscitation(ILCOR)for ongoing clinical evidence review. The update continues with the view of 2015's edition that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia. The flow chart of cardiac arrest for pediatric advanced life support was slightly adjusted.

This paper reported a new type of amylase (neoamylase) secreted by a Bacillus strain ZX99. The enzyme was a kind of ectoenzyme that could catalyze starch into isomalto-oligosaccharide effectively, but could not act on pullulan as substrate. The strain Bacillus ZX99 was mutated by ultraviolet ray and a mutant strain BS3.232 was screened. The activity of the neoamylase produced from BS3.232 increased by 60% over that from ZX99 under the same conditions. The results of thin-layer chromatography of products from starch and pullulan catalyzed by the enzyme demonstrated that the enzyme was different from neopullulanase and can be used to produce isomaltooligosaccharide from starch, including isomaltose, panose, isomaltotriose, isomaltotetose.

OBJECTIVETo study the correlation between the blood serum brain natriuretic peptide (BNP) level and the left cardiac function in children with congenital heart disease (CHD).

METHODSThe clinical data of 41 CHD children were retrospectively analyzed. Patients were divided into two groups based on the existence of congestive heart failure (CHF): CHD+CHF (n=21) and CHD alone (n=20). The blood serum BNP level was determined using chemiluminescence immunoassay, and the left ventricular ejection fraction (LVEF) was measured with echocardiogram.

RESULTSThe serum BNP level was 1353 pg/mL (range: 926-2978) in the CHD+CHF group, which was significantly higher than in the CHD alone group[149 pg/mL (range: 75-242)] (P<0.01). The LVEF was 60% (range: 53%-65%) in the CHD+CHF group, which was significantly lower than in the CHD alone group[68% (range: 64%-72%)] (P<0.01). The serum BNP level showed a negative correlation with the LVEF level (r=-0.652, P<0.01).

CONCLUSIONSThe blood serum BNP level is related to the cardiac function. For children with severe CHD+CHF, serum BNP level can be used as a sensitive indicator for evaluating cardiac function damage.

Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; blood ; physiopathology ; Humans ; Infant ; Male ; Natriuretic Peptide, Brain ; blood ; Stroke Volume ; Ventricular Function, Left

Cardiomyopathies ; diagnosis ; therapy ; Carnitine ; deficiency ; Female ; Humans ; Hyperammonemia ; diagnosis ; therapy ; Infant ; Muscular Diseases ; diagnosis ; therapy

OBJECTIVETo evaluate the diagnostic value of measuring serum C-reactive protein (CRP) and procalcitonin (PCT) levels, within 6 hours after admission to the pediatric intensive care unit (PICU) in children with bloodstream infection (BSI)-associated sepsis and septic infection at other sites.

METHODSA retrospective analysis was performed on 30 children with a confirmed diagnosis of systemic inflammatory response syndrome who were admitted to the Shengjing Hospital of China Medical University between January 2010 and January 2012. Clinical data on serum CRP, PCT and D-dimer levels were collected within 6 hours after admission. The diagnostic values of the indices were determined by comparative analysis.

RESULTSSerum CRP and PCT levels in children with BSI-associated sepsis were significantly higher than in children with septic infection at other sites (P<0.05), but there was no significant difference in serum D-dimer levels between the two groups (P>0.05). Serum PCT level was superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites. Serum PCT level could not realistically be used for diagnosing BSI-associated sepsis when it was less than 2 ng/mL (negative predictive value: 100%), but could be reliably used when it was more than 10 ng/mL (positive predictive value: 77%).

CONCLUSIONSSerum PCT level is superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites within 6 hours after admission to the PICU. Serum PCT level has a better diagnostic value for BSI-associated sepsis when it is more than 10 ng/mL.

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Protein Precursors ; blood ; Retrospective Studies ; Sensitivity and Specificity ; Sepsis ; blood ; diagnosis

OBJECTIVEThis study examined the protein and mRNA contents of angiotesin converting enzyme (ACE), angiotensin II (Ang II) and type I collagen and the changes of lung histomorphology in neonatal rats with hyperoxia-induced chronic lung disease (CLD) and investigated the protection of captopril against CLD and the possible mechanism.

METHODSA total of 240 term neonatal Wistar rats were randomly assigned into air, model, normal saline and captopril-treated groups (n=60 each). The air group was exposed to room air (FiO2=0.21) immediately after birth. The other three groups were exposed to hyperoxia (FiO2=0.9) for 21 days to induce lung injury. The captopril-treated group received captopril daily (30 mg/kg) by intragastric administration between the 7th and 21st days of hyperoxia exposure. The normal saline group was administrated with normal saline instead. At each time interval of 1, 3, 7, 14 and 21 days after experiment, six rats of each group were randomly chosen and sacrificed. The protein and mRNA levels of ACE, Ang II and type I collagen were measured by enzyme-linked immunosorbentassay, radio-immunity technique and RT-PCR. The changes of lung histomorphology were observed under a light microscope.

RESULTSThe protein and mRNA expressions of ACE, Ang II and type I collagen increased significantly in the model and normal saline groups on the 14th and peaked on the 21st days of exposure compared with those of the air group (P < 0.05 or 0.01). Captopril treatment reduced significantly the protein and mRNA expressions of ACE, Ang II and type I collagen compared the model and normal saline groups on the 14th and 21st days, although the values were significantly higher than the air group (P < 0.05 ). The histopathologic examination demonstrated broadened lung interstitium and reduced alveolar quantity and lung fibrosis was developed in the model and normal saline groups on the 14th day of exposure. Captopril treatment obviously alleviated the changes of lung histomorphology.

CONCLUSIONSCaptopril can inhibit the protein and mRNA expressions of ACE, Ang II and type I collagen and alleviate lung fibrosis in neonatal rats with hyperoxia-induced lung injury/CLD. This may contribute to one of the possible mechanisms underlying the protective effects of captopril against lung injury/CLD.

Animals ; Animals, Newborn ; Body Weight ; drug effects ; Captopril ; therapeutic use ; Chronic Disease ; Collagen Type I ; analysis ; Hyperoxia ; complications ; Lung ; metabolism ; pathology ; Lung Diseases ; prevention & control ; Peptidyl-Dipeptidase A ; analysis ; genetics ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar

OBJECTIVETo study the etiology of acute upper respiratory tract obstruction in infants.

METHODSThe medical data of 12 infants with acute upper respiratory tract obstruction were retrospectively reviewed. The patients received the examinations of laryngoscopy and CT scans for larynx and lungs.

RESULTSAll of the 12 infants presented with laryngeal stridor. Eight infants (67%) were diagnosed as congenital simple laryngeal stridor before admission. Based on the clinical features, laboratory examinations, imaging examinations and laryngoscopy, 4 (33%) were definitely diagnosed with thyroglossal ductal cyst, 1(8%) with abscess-emphysema in the posterior wall of pharynx, 1(8%) with cervicallymphangioma, 2 (16%) with subglottic stenosis, and 4 (33%) with acute laryngitis.

CONCLUSIONSAcute upper respiratory tract obstruction is easily misdiagnosed in infants. Thyroglossal duct cyst is a common cause of upper respiratory tract obstruction/laryngeal stridor. It is recommend that laryngoscopy and CT scans for larynx should be performed in infants with laryngeal stridor.

Acute Disease ; Female ; Humans ; Infant ; Laryngoscopy ; Laryngostenosis ; congenital ; diagnosis ; etiology ; Male ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed