Objective To investigate the effects of Propofol in blood spinal cord barrier (BSCB) disruption induced by spinal cord ischemia reperfusion injury (SCIRI). Methods 72 Japanese white rabbits were randomly assigned into 3 groups: sham-operation group (S); ischemia/reperfusion group (I/R) and Propofol treatment group (I/R + P). The Group S was separated the aorta without cross-clamping. SCIRI was induced in rabbits by infrarenal aortic occlusion for 30 minutes. Propofol was intravenously infused at 10 minutes before aortic clamping and at onset of reperfusion in the Group I/R + P. The Group S and Group I/R were intravenously infused 0.9%sodium chloride. Hind-limb motor function was assessed using Tarlov criteria, and histological observation by histological examination. The permeability of the BSCB was examined using EB as vascular tracers. The expression of MMP-9, claudin-5 and NF-κB were assessed by Western blot, RT-PCR. Results Propofol minimized the neuromotor dysfunction and histopathological deficits and attenuated EB extravasation. In addition, Propofol suppressed SCIRI-induced increase of MMP-9 and NF-κB. Finally, Propofol reduced the loss of claudin-5. Conclusion Propofol stabilizes the BSCB integrity after SCIRI. This beneficial effect is partly mediated by inhibition of MMP-9 and preservation claudin-5 and relates to inhibiting the NF-κB signal pathway.

Objective To investigate epidemiological and clinical features of patients with clonorchiasis sinensis infection. Methods The epidemiological, clinical, laboratory and treatment data of clonorchiasis patients in Department of Infectious Diseases, Second Affiliated Hospital, Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Results Sixty-eight point two percent patients had a history of eating raw freshwater fish and shrimp. Patients with occupations as cook, fish stock man, fishing man and fishmonger accounted for 22.6%. The transmission route was not clear in 9.1% of patients. The common clinical manifestations were abdominal pain (60.3%), fatigue (52.3%), diarrhea (33.0%), anorexia (69.3%), jaundice (23.9%), hepatomegaly (59.1%), splenomegaly (8.0%), dizziness (20.9%), fever (5.7%) and biliary colic (14.8%). Twenty-eight point four percent were asymptomatic. Other findings included liver dysfunction (70.4 %) and eosinophile granulocyteosis(69.3 %). Negative rate of stool egg of clonorchis sinensis after treatment with praziquantel or albendazole was 91.9% or 86.5%, respectively. There was no significant difference between the two groups ( χ2 = 0.561, P = 0.454). Conclusions Clinical manifestations of patients with clonorchiasis sinensis are complicated and often accompanied with liver dysfunction. Clonorchiasis sinensis is often misdiagnosed and should be paid much attention.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.

Objective:To implement the teaching activities for cultivating the four characteristics (innovation, development, integration, and ecology) and the four abilities (political ability, learning ability, cross-border ability, and driving force), and to provide a reference for improving the capability of service-based education in basic teaching organizations.Methods:The basic teaching organization in School of Basic Medical Sciences, Qiqihar Medical University, was selected for research, and the action research method and the focus group interview method were used to carry out characteristic teaching activities around the cultivation of the four characteristics and the four abilities. After the implementation of these activities, Sojump, a questionnaire platform, was used to conduct a survey among full-time and part-time teachers and teaching administrators, and the effect of each activity on the cultivation of the four characteristics and the four abilities was analyzed. The strategies to enhance abilities were improved based on the results of the above analyses. SPSS 25.0 software was used for data processing, and categorical data were expressed as frequency and percentage.Results:The data analysis showed that through cultivation of the four characteristics and the four abilities, each designed activity had a remarkable effect on improving the capability of service-based education in the basic teaching organization, with a mean value of 80.77%(63/78)- 91.03%(71/78), and only the activities centered on "integration" had a relatively low value of "obvious effect", which accounted for 64.10%(50/78).Conclusion:Under the guidance of the new concept of "New Medicine" and with the opportunity of capacity building, a series of teaching activities focusing on the four characteristics and the four abilities can effectively improve the capability of service-based education in basic teaching organizations in colleges and universities through targeted ability training.

Objective:To investigate the effects of early sleep deprivation(SD) on depressive-like behavior and hippocampus synaptic plasticity in adult mice with chronic unpredictable mild stress(CUMS) model.Methods:Thirty 2-week-old clean grade male mice were randomly divided into control group (CON group), CUMS group and SD + CUMS group according to the random number table, with 10 mice in each group. The mice in SD + CUMS group were subjected with sleep deprivation for 4 hours once a day during puberty (3 ~ 6 weeks old), and then were stimulated by CUMS after adulthood (9 weeks old). The mice in CUMS group were subjected with CUMS at the age of 9 weeks. And the mice in CON group were not given any intervention.The depressive-like behavior was evaluated by body weight, sugar water preference, tail suspension test and forced swimming test.The density of dendritic spines of basal and apical neurons in hippocampal CA1 was measured by Golgi staining, the frequency and amplitude of miniature excitatory postsynaptic current(mEPSC) of pyramidal neurons in the hippocampal CA1 region of mice were measured by electro-physiological patch clamp technique.Graphpad prism 7.0 software was used for statistical analysis and mapping. One-way ANOVA was used for comparison among multiple groups, and Tukey test was used for further pairwise comparison.Results:(1) After stress modeling, there were significant differences in body weight, sugar water preference percentage, forced swimming immobility time and tail suspension time among the three groups ( F=71.63, 39.82, 44.13, 43.07, all P<0.01). Compared with CON group, the mice in CUMS group and SD+ CUMS group had lower body weight ((25.51±0.37) g, (22.92±0.31) g, (20.12±0.27) g, both P<0.01), lower sugar water percentage preference ((87.40±1.65) %, (63.42±3.33) %, (49.68±3.70)%, both P<0.01), longer immobile time of forced swimming ((34.30±5.32) s, (119.20±12.03) s, (153.80±9.17) s, both P<0.01) and longer immobile time of tail suspension test((115.20±8.19)s, (156.80±4.35) s, (192.00±4.12) s, both P<0.01). Compared with CUMS group, SD+ CUMS group had lower body weight ( P<0.01), lower sugar water preference percentage ( P<0.05), longer immobile time in forced swimming test( P<0.05) and longer immobile time in tail suspension test( P<0.01). (2) Golgi staining results showed that the densities of dendritic spines of apical neurons and basal neurons in hippocampal CA1 area of the three groups were significantly different ( F=38.41, 41.34, both P<0.01). The densities of dendritic spines of basal and apical hippocampal neurons in CUMS group and SD+ CUMS group were lower than those in CON group ((7.74±0.22)/10 μm, (6.58±0.27)/10 μm, (5.00±0.13)/10 μm, both P<0.01), ((8.90±0.23)/10 μm, (7.63±0.30)/10 μm, (6.01±0.14)/10 μm, both P<0.01). Compared with CUMS group, the mice in SD+ CUMS group had lower densities of dendritic spines of basal and apical hippocampal neurons(both P<0.01). (3) Electrophysiological results showed that there were significant differences in the frequency and amplitude of mEPSC in hippocampal pyramidal neurons of the three groups ( F=38.90, 63.37, both P<0.01). Compared with CON group, the frequency and amplitude of mEPSC in pyramidal neurons of CA1 in CUMS group and SD+ CUMS group were significantly lower ((0.39±0.03)Hz, (0.20±0.02)Hz, (0.07±0.02)Hz, both P<0.01; (9.98±0.31)pA, (7.74±0.21)pA, 6.36±0.13)pA, both P<0.01). Compared with CUMS group, the frequency and amplitude of mEPSC in SD+ CUMS group were lower (both P<0.01). Conclusion:Adolescent sleep deprivation aggravates depressive behavior and hippocampus synaptic plasticity impairment in adult CUMS model mice.

Objectives To analyze the clinical characteristics, treatment and prognosis of necrotizing pneumonia caused by Mycoplasma pneumoniae (MP) infection in children. Method The clinical data of children with necrotizing pneumonia cause by MP infection from October 2016 to October 2017 were retrospectively analyzed. Results A total of 26 children (10 males and 16 females) with an average age of (5.76±2.60) years, were enrolled in the study. All children were characterized by fever and cough. High fever ( ≥ 39.0 ℃) was seen in 23 cases (88.5％) and the total duration of fever was (16.88±7.42) days. Pulmonary auscultation showed a reduction in respiratory sounds in all children. The range of peripheral blood leukocytes were (9.0～36.8) ×109/L, mean peak neutrophil ratio was (69.2±13.2) ％, and the range of C-reactive protein (CRP) was (1～202.5) mg/L. The mean value of lactic dehydrogenase (LDH) was (448±247) U/L. At the beginning of the disease, the chest images showed homogeneous solid high-density images over the whole lung lobe and 20 cases (76.9％) were complicated with pleural effusion. At the later stage, lung CT showed thin-walled cavities or multiple air-containing cysts on the basis of lung consolidation. Fiberoptic bronchoscopy showed lumen obstruction caused by mucus plugs in 23 cases (88.5％) . All the children were treated with methylprednisolone. The dose of 2 mg/ (kg·d) was effective in 21 cases and the fever was relieved in 5 cases after the dose was adjusted to 4 mg/ (kg·d) , and the average hormone application time was (13.08 ± 8.38) d. The median length of hospital stay was [16.5 (7～32) ] d. Two cases were lost to follow-up and 24 cases finished 6-month follow-up. Lung CT showed almost complete recovery of the lungs in 16 cases, residual pleural hypertrophy in 5 cases, and bronchiectasis in 1 case and bronchiolitis obliterans in 2 cases. Conclusion Necrotic pneumonia in children caused by MP infection is characterized by persistent high fever, decreased respiratory sounds, lung consolidation and mucus plugs induced lumen obstruction. The prognosis is relatively good after active anti-infection and hormone therapy.

Objective: To explore the anti-inflammatory immune mechanism in moxibustion treatment of Crohn.s disease (CD) from the perspective of c-Jun N-terminal kinase (JNK) signaling pathway, through observing the regulatory effect ofmoxibustion on colonic JNK, c-Jun, monocyte chemoattractant protein 1 (MCP-1) and cyclooxygenase 2 (COX2) in CDmodel rats. Method: Male Sprague-Dawley rats of clean grade were randomized into a normal group, a model group, amoxibustion group and a sham moxibustion group. CD model was developed by the mixture of 2, 4, 6 Trinitro-benzene-sulfonic acid (TNBS) and ethanol via enema. Hematoxylin-eosin (HE) staining was used to observe the morphologicalchanges in rat.s colon tissues for pathological scoring; enzyme-linked immunosorbent assay (ELISA) was used to detectthe contents of MCP-1, COX2, JNK, and c-Jun in colon tissues; real-time fluorescence quantitative PCR was adopted toexamine the mRNA expressions of JNK and c-Jun in rat.s colon. Result: Compared with the normal group, the modelgroup showed more significant colonic damage and thus had a higher colonic damage score (P ＜ 0.01), manifested astopical inflammation which involved the submucosa, fissuring ulcers and granuloma; the model group also showedincreased contents of protein MCP-1 and COX2, and elevated contents of JNK protein and mRNA in colon (all P ＜ 0.05), while the change in the content of c-Jun was insignificant (all P＞ 0.05) . Compared with the model group and shammoxibustion group, the colonic damage score was lower in the moxibustion group (P ＜ 0.01, P ＜ 0.05), with improvementin colonic structure and inflammation; the contents of MCP-1 and COX2 in colon tissues declined, so did the proteincontent and mRNA expression of JNK (all P ＜ 0.05), while the change in the content of c-Jun was insignificant (all P＞0.05) . There were no significant differences between the model group and sham moxibustion group comparing all theindexes (all P＞ 0.05) . Conclusion: Moxibustion down-regulates the expressions of JNK protein and mRNA in CD rat.scolon, as well as the contents of MCP-1 and COX2 in colon tissues, which is possibly one significant mechanism formoxibustion to ease intestinal inflammation and promote the repair of colon tissues in CD.

Objective:To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with sorafenib and sequential microwave ablation (MWA) versus TACE combined with sorafenib in the treatment of hepatocellular carcinoma (HCC) with tumor diameter over 5 cm, and to analyze risk factors affecting the prognosis of patients.Methods:The prospective cohort study was conducted. The clinicopathological data of 61 HCC patients with tumor diameter over 5 cm who were admitted to two medical centers (30 in the Laiyang Central Hospital of Yantai City Affiliated to Weifang Medical College and 31 in the Qingdao Central Hospital Affiliated to Qingdao University) between July 2012 and November 2013 were collected. Patients who were treated with TACE combined with sorafenib and sequential MWA were allocated into observation group, and patients who were treated with TACE combined with sorafenib were allocated into control group. Observation indicators: (1) treatment, complications and adverse drug reactions; (2) short-term efficacies; (3) follow-up and survival situations; (4) analysis of prognostic factors. Follow-up was performed by inpatient, outpatient examinations or telephone interview once a month within the first 6 months after treatment and once every 3 months thereafter up to November 2018. The follow-up included laboratory indicators, tumor markers, abdominal enhanced computed tomography or magnetic resonance imaging examinations. The survival of patients and disease progression were fully documented. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution were described as M (range), and comparison between groups was performed using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or pearson-corrected chi-square test. Ranked data were analyzed using the Wilcoxon rank sum test. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. The Log-rank test was used for survival analysis. Comparison of survival rates between time points was performed using the Bonferroni method to adjust the test level. Univariate and multivariate analyses were performed using the multiple COX proportional hazard model. Results:A total of 61 HCC patients were selected for eligibility, including 36 males and 25 females, aged (58±8)years, with a range from 43 to 73 years. Of the 61 patients, 31 were in the observation group and 30 in the control group. (1) Treatment, complications and adverse drug reactions: ① treatment information. The treatment times of TACE, treatment times of MWA, time from the first TACE to the first sorafenib medication, and duration of sorafenib medication in the observation group were 1 time (range, 1-5 times), 2 times (range, 1-4 times), 5 days (range, 5-9 days), 24 months (range, 6-72 months), respectively. The above indicators of patients in the control group were 3 times (range, 1-5 times), 0, 6 days (range, 5-9 days), and 16 months (range, 6-60 months). There were significant differences in the treatment times of TACE, treatment times of MWA, and duration of sorafenib medication between the two groups ( Z=4.701, -7.213, -2.614, P<0.05). There was no significant difference in the time from the first TACE to the first sorafenib medication between the two groups ( Z=0.573, P>0.05). ② Complications: there was no TACE related complications in the two groups. There were 3 patients with MWA related complications in the observation group, including 2 cases of minor hemorrhage under the liver capsule and 1 case of pleural effusion, and they were relieved after conservative treatment. ③ Adverse reactions to sorafenib: after 2 months of sorafenib medication, patients in the observation group and control group had at least one kind of sorafenib related stage Ⅰ-Ⅲ adverse reaction, without stage Ⅳ adverse reaction. The numbers of cases with hand-foot skin reaction, rash, pruritus, loss of skin pigmentation, diarrhea, decreased appetite, nausea and vomiting, pain in the liver area, fever, fatigue, liver dysfunction, bone marrow suppression were 8, 3, 4, 3, 10, 18, 20, 20, 20, 15, 3, 2 in the observation group, and 9, 3, 3, 2, 13, 19, 23, 12, 21, 12, 6, 2 in the control group, respectively, showing no significant difference in the above indices between the two groups ( χ2=0.133, 0.000, 0.000, 0.000, 0.796, 0.177, 1.082, 3.674, 0.208, 0.435, 0.601, 0.000, P>0.05). Patients with adverse reactions to sorafenib were relieved by symptomatic treatment, reducing the dose of sorafenib or intermittent drug withdrawal. (2) Short-term efficacies: the level of alpha fetoprotein was 16 μg/L (range, 3-538 μg/L) in the observation group and 292 μg/L (range, 9-642 μg/L) in the control group after one month of treatment, showing a significant difference between the two groups ( Z=3.744, P<0.05). After 3 months of treatment, cases with tumor complete remission, cases with tumor partial remission, cases with stable disease, cases with progressive disease, objective response rate, and disease control rate in the observation group were 14, 11, 6, 0, 80.6%(25/31) , 100.0%(31/31), respectively. The above indicators in the control group were 2, 13, 12, 3, 50.0%(15/30), 90.0%(27/30). There was a significant difference in the objective response rate between the two groups ( χ2=6.343, P<0.05), but no significant difference in the disease control rate between the two groups ( χ2= 1.473, P>0.05). (3) Follow-up and survival situations: 61 HCC patients were followed up for 9.0-75.0 months, with a median follow-up time of 22.0 months. During the follow-up, 28 patients in the observation group had progressive disease, including 8 cases of local tumor progression, 4 of portal vein tumor thrombi, 11 of intrahepatic metastasis, and 5 of pulmonary metastasis. Thirty patients in the control group had progressive disease, including 13 cases of local tumor progression, 6 of portal vein tumor thrombi, 6 of intrahepatic metastasis, and 5 of pulmonary metastasis. Among the 61 patients, 28 patients in the observation group and 29 patients in the control group died. The median overall survival time and median progression-free survival time of the observation group was 28.0 months and 18.0 months, versus 19.5 months and 11.5 months of the control group, showing significant differences between the two groups ( χ2=8.021, 10.506, P<0.05). The 1-, 3-, 5-year overall survival rates of the observation group were 97%, 37% and 20%, respectively, versus 83%, 13% and 7% of the control group, showing significant differences in the above indicators between the two groups ( Z=23.635, 4.623, 3.139, P<0.0167). The 1-, 2-, 3-year progression-free survival rates of the observation group were 77%, 40%, and 27%, respectively, versus 43%, 13%, and 7% of the control group, showing significant differences in the above indicators between the two groups ( Z=9.965, 4.900, 3.684, P<0.0167). (4) Analysis of prognostic factors: results of univariate analysis showed that treatment method, maximum tumor diameter, Barcelona clinical liver cancer (BCLC) stage, liver cirrhosis, hepatitis B virus(HBV) infection, and Child-Pugh classification were related factors for overall survival time [ hazard ratio ( HR)=0.483, 6.196, 12.646, 5.049, 2.950, 4.791, 95% confidence interval ( CI): 0.284-0.823, 3.198-12.003, 5.031-31.785, 2.586-9.858, 1.366-6.369, 2.507-9.155, P<0.05] and progression-free survival time ( HR=0.427, 5.804, 7.032, 5.405, 2.925, 4.410, 95% CI: 0.248-0.735, 3.043-11.070, 3.071-16.101, 2.685-10.881, 1.364-6.270, 2.331-8.342, P<0.05). Results of multivariate analysis showed that treatment method, maximum tumor diameter, BCLC stage, liver cirrhosis, and HBV infection were independent influencing factors for overall survival time ( HR=0.183, 5.886, 17.544, 4.702, 3.801, 95% CI: 0.090-0.370, 2.648-13.083, 5.740-53.622, 1.928-11.470, 1.368-10.562, P<0.05) and progression-free survival time ( HR=0.201, 3.850, 3.843, 3.598, 3.726, 95% CI: 0.098-0.411, 1.761-8.414, 1.526-9.682, 1.444-8.963, 1.396-9.947, P<0.05). Conclusions:Compared with TACE combined with sorafenib, TACE combined with sorafenib and sequential MWA is safe and effective in the treatment of HCC with tumor diameter over 5 cm. The treatment method, maximum tumor diameter, BCLC stage, liver cirrhosis, and HBV infection are independent influencing factors for overall survival time and progression-free survival time of patients.

Objective To investigate the association between depression behavior and the expression of calreticulin precursor, tropomyosin I, milogen activated prolein kinase 1 and dual specificity mitogen-activated protein kinase 1 in spontaneous diabetes mellitus rats. Methods Twenty adult male healthy rats (control group) and 40 spontaneous diabetic rats were studied. Forty spontaneous diabetic rats were further divided into diabetes group and diabetic depression group, and the latter was to construct depression model. The depressive behavior of the 3 groups was measured by sucrose water consumption test and wilderness test. The expression level of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogen-activated protein kinase 1 in the hippocampus of the 3 groups was measured by western blot. Results In the 15 th day and 22 nd days of stress, the amount of sucrose water drinking of the rats in diabetic depression group was significantly lower than that of the control group and the diabetes group (P < 0.05) , and there was no significant difference between the control group and the diabetic group (P> 0.05). The score of field test and vertical score in the diabetic depression group were significantly lower than those of the control group and the diabetes group (P < 0.05) , but there was no significant difference between the control group and the diabetic group (P> 0.05). The expression of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogen-activated protein kinase 1 in the hippocampus of diabetic depression group was significantly lower than that in the control group and the diabetic group (P < 0.05) , and there was no significant difference between the control group and the diabetic group (P> 0.05).Conclusions The depressive behavior of spontaneously diabetic rats is associated with the decrease of the expression level of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogenactivated protein kinase 1 in the hippocampus of rats.

Objective:To explore the clinical characteristics of Mycoplasma pneumoniae (MP) bronchiolitis to provide references for clinical prevention and treatment.Methods:From January 2019 to January 2020, the clinical data of children diagnosed with MP bronchiolitis in the Department of Respiratory 2 of Hebei Children′s Hospital were retrospectively collected and analyzed, and the patients were followed up to observe the prognosis.Results:Among the 67 children, there were 39 boys and 28 girls, with age of 5 (1-14) years.All the children had cough, 63 cases (94.0%) had fever, 49 cases (77.8%) had high fever (≥39.0 ℃), and the median total fever course was 8(1-27) d; 10 cases (14.9%) had wheezing; 5 cases (7.5%) had dyspnea; 3 cases (4.5%) had hypoxemia; wet rales were heard in 58 cases (86.6%) and wheezing in 10 cases (14.9%). Forty-eight patients (71.6%) had family allergy history or personal allergy history.The average value of peripheral blood white blood cells was (8.6±2.6)×10 9/L; the me-dian of C reactive protein was 9.1(0.5-55.6) mg/L, of which 7 cases (10.4%) were ≥30 mg/L; the median of lactate dehydrogenase was 278(181-590) U/L.Tree bud sign and central lobular nodules were the main findings of high-resolution CT of the chest.Among them, 45 cases (67.2%) had bilateral lesions, 38 cases (56.7%) involved ≥3 lung lobes, and 22 cases (32.8%) had a little lung consolidation, 19 cases (28.4%) had a small amount of pleural effusion.The bronchoscopic features of 35 children (52.2%): 71.4%(25/35 cases) showed white flocculent and cord-like secretions, 17.1%(6/35 cases) displayed mucus plugs blocking the lumen, and 10.9%(4/35 cases) showed no-dular protrusions and granulation tissue hyperplasia.All children were treated with Azithromycin sequentially; 42 children (62.7%) were treated with low-dose hormones, and the average initiation time was on day (10.62±2.71) and the median course was 14(2-42) d. Sixty-seven cases were followed up for half a year, of which 61 cases (91.0%) had almost complete lung recovery, and 6 cases (9.0%) developed bronchiolitis obliterans (BO). Conclusions:MP bronchiolitis mostly occurs in infants and preschool children with a family history of allergies or personal allergies.Fever and cough are the main clinical manifestations.In severe cases, dyspnea and hypoxemia may occur.The physical signs of the lungs are mainly include wet rales, some of which are wheezing.White flocculent and cord-like secretions are the main manifestations of bronchoscopy.After active treatment, most children have a good prognosis, and some children may develop BO.