Objective To dynamically measure cardiac output in shock neonates and to explore its clinical values.Methods The cardiac output and stroke volume of left ventricle in 30 shock neonates and 30 normal neonates were measured by noninvasive ultrasonic cardiac output monitor (USCOM) and the measurement was repeated in shock neonates after volume expansion and dopamine(2-4μg/(kg·min))treatment.Results The cardiac output and stroke volume of left ventricle in shock neonates ((0.36 ± 0.24) L/min,(3.5 ± 1.5) cm~3) were significantly lower than those in normal neonates ((0.49 ± 0.15) L/min,(2.7 ± 1.6) cm~3)) and however were improved significantly after volume expansion and dopamine treatment ((0.52 ± 0.28) L/min,(3.8 ± 1.8) cm~3).The urine volume was also increased significantly after treatment (P < 0.05).Conclusions Dynamic measurement of the cardiac output in early shock neonates might offer guidance on clinical fluid resuscitation.

Septic shock may have a lasting effect on all human endocrinologic, coagulatory and metabolic regulatory circuits with the consequence of severe dysregulation of homoeostasis.Adjunctive therapeutic options like correction of metabolic acidosis, intensive insulin therapy, and modulation of coagulation by drotrecogin alfa (activated) are still controversial.However, these adjunctive therapeutic options should be selected according to the national and international guidelines.

Interleukin(IL),generated by immunocytes or non-immune cells,is a group of cell factors that holds many important biological effects. Up to now,with the rapid progress of molecular biology and cell biology technique,29 types(IL-1 ～ IL-29)of IL have been reported since its denomination in 1979. IL-23,one kind of interleukin found in 2000,is composed of p19 and p40 sub group. Recent studies showed that it has various biological functions,such as acting on T cell to make it produce various cell factors,acting on DC and MP to affect the secretion of the relevance cell factors. The biological functions of IL-23 have played an important role in various diseases. This review describes the molecular structure,biological function,and its effects on related diseases.

Objective To perform a follow-up study on psychomotor development in children conceived with assisted reproductive technology. Methods A control-matched study was done including 63 infants born after assisted conception (study group)and 65 natural conception infants(control group). The pregnant women agreed to participate in the study when they were at 28 weeks of gestation and were followed-up in a predefine schedule till delivery. The regular developmental assessment was done with the CDCC Scales of Infant Development for the children of two groups till they were 24 months old. Results The mean birth weight and length were lower in the study group than those of the control group. The incidences of preterm birth,low birth weight,and NICU admission were significantly higher in the study group than those of control group. However,these differences were not significant when only singletons were compared between two groups. No statistical differences were found in the mental development index(MDI)and psychomotor development index(PDI)between two groups. Conclusions Psychomotor development of children born after assisted conception is normal at 24 months of age. Since the incidences of preterm birth,low birth weight,and multifetation are significantly higher in children born after assisted conception,their general health and development should be followed up for a longer time.

To explore the role of cerebro-spinal flu id(CSF)glutamate and nitric oxide (NO) in the pathogenesis of neonatal hypoxic- ischemia encephalopathy (HIE), glutamate and NO in CSF were determined in 24 new born infants with HIE and 8 normal control infants, respectively. The results sh owed that the levels of glutamate and NO in CSF were significantly higher in the neonates with moderate and severe HIE than those in both of the control group an d neonates with mild HIE.There was an obviously positive relationship between le v els of glutamate and NO. It is concluded that glutamate and NO play an important role in the pathogenesis of neonatal HIE.

Objective To investigate the characteristics of Wegener granulomatosis in children and to improve its recognition. Methods Ten pediatric patients with Wegener granulomatosis were studied retrospectively by clinical manifestations, serum examination, pathological data, treatment, etc. Results All children had clinical evidence of upper respiratory tract and lungs involvement; kidney lesion occurred in 6 cases(6/10); joints, skin, eyes and nervous system were also involved with different degree, cANCA (PR3) showed positive in 8 cases; Pathological examination (1 kidney sample, 2 nasal mucosa samples, 2 skin samples) showed granulomatous vasculitis and crescents were found in renal biopsy; 7 cases were treated with corticosteroid plus cyclophosphamide, 1 case was treated with corticosteroid plus methotrexate, and improvement were seen in all of them. Conclusions Wegener granulomatosis in children have diverse clinical manifestations and clinical diagnosis is difficult. The upper and lower respiratory tract and kidney are most commonly involved organs. ANCA inspection is characteristic. Treatment with corticosteroid and immunosuppressive can achieve good outcome.

Objective To analyze the expression of dystrophin associated glycoprotein complex (DGC) in Duchnne muscular dystrophy (DMD) in different age groups. Methods The confirmed 24 DMD patients were divided into 3 groups according to their chronological age (children whose age between 1 to 3 were assigned to early childhood group; children whose age between 3 to 6 were assigned to preschool group; children whose age between 6 to 13 were assigned to school-age group). Several proteins from sarcolemmal muscle membrane were analyzed by immunohistocbemistry. Results The primary loss of dystrophin may lead to a secondary or completely deficiency of α-SG, β-SG, γ-SG,δ-SG, β-DG and dysferlin from sarcolemmal muscle membrane in different age groups. The expression of nNOS is completely deficient in the 3 groups, while the expression of caveolin-3 increased. Conclusions The expression of dystrophin related DGC proteins from DMD patients in different age groups showed diversed degrees of deficiency or complete deficiency. The deficiency of these proteins may occur during the embryonic period, while the increased expression of eaveolin-3 may have a relation with the regeneration of skeletal muscle fibers.

Objective To explore the relationship between expression of P-glycoprotein (P-gp), a product of multidrug resistance (MDR) gnne, in the peripheral blood of children with intractable or newly diagnosed epilepsy for drug resistance. To establish a marker of drug resistance. To evaluate the therapeutic effect of flunarizine in the treatment of intractable epileptic patient with or without overexpression of P-gp. Methods The expression of P-gp in peripheral blood were investigated in 86 epileptic children (41 in intractable epilepsy group, 45 in newly diagnosed epilepsy group) and 44 healthy children (controlled group) by flow cytometry. Intractable epileptic patients with or without overexpression of P-gp were given flunarizine 2.5 - 5 mg, po, qn, for 3 months and followed up. Results Overexpression of P-gp were found in 23 (56.1%) patients of intractable epilepsy group, in 10 (22.2%) patients of newly diagnosed epilepsy group and three (6.8%) children of the controlled. In intractable epilepsy group, 17 out of 23 cases (73.9%) patient with overexpression of P-gp became tolerant to antiepileptic drugs, while 3 out of 18 cases (16.7%) patient without expression of P-gp became tolerant to antiepileptic drugs, and there was significant difference between them (P < 0.01) . In the newly diagnosed epilepsy group, seven out of 10 cases (70%) with overexpression of P-gp became intractable epileptic patient and three out of 35 eases (18.6%) without expression of P-gp became intractable epileptic patient, there was significant difference between them (P < 0.01). Twenty patients of intractable epilepsy group were given flunarizine for three months, 11 of 17 patients with P-gp overexpression and 1 of 3.patients without P-gp expression were effective. When reexamined, P-gp expression in 6 out of 11 patients became negative. Conclusions It is suggested that overexpression of P-gp in the peripheral blood of intractable epileptic patients might be a significant marker of drug resistance. Newly diagnosed epileptic patients with overexpression of P-gp may develop intractable epilepsy. P-gp was a predictable marker of intractable epilepsy. Flunarizine could be a choice in treatment of intractable epilepsy with overexpression of P-gp. The antiepileptic mechanism of flunarizine may involve in reversing of P-gp.

Objective To study the expression and significance of multidrug resistance gene (MDR1) in children with refractory epilepsy (RE). Methods Children with RE (n = 30), non-RE (n = 30) and healthy children (n=30) were collected. The expression of MDR1-mRNA in peripheral blood was analyzed by fluorescence quantitative PCR. The relationship of MDRI-mRNA with epileptic frequency and numbers of antiepileptic drugs (AEDs) were observed. Results The expression of MDR1 in RE group obviously increased when compared with that of non-RE group and healthy group (P < 0.01, P < 0.01) ; MDR1 expression was more among patients with high frequent epilepsy than patients with low frequent epilepsy (P < 0.01) ; more in patients administered with four kinds of AEDs than those with two or three kinds of AEDs (P < 0.01). Concinsions MDR1 overexpression in blood of children with RE may be linked to drug-resistant mechanism of RE. It might be used as a clinical indicator of RE.

The development of human gut flora, its biological functions of providing resistance to infections and allergy was reviewed. Potential risks of cesarean-section in terms of enteric infections and allergy of new born infants and the efficacy of probiotics and prebiotics in the prevention as well as treatment of infections/allergy were evaluated in this article.