OBJECTIVE:To evaluate status quo of the application of antibiotics for children and its trend.METHODS:The data about the amount and money of antibiotics used from2002to2005in out patient pharmacy of our hospital are collected and analyzed.RESULTS:Cephalothin,penicillin and azithromycin were widely used in our hospital and the using situation was reasonable at large,but some problems still existed.CONCLUSION:Rational using of antibiotics need efforts of all the departments in the hospital.

Objective To study whether sevoflurane pretreatment inhibits the myocardial apoptosis caused by hypoxia reoxygenation through AMPK pathway. Methods H9c2 myocardial cell lines were cultured and divided into control group (C group), hypoxia reoxygenation group (H/R group), sevoflurane pretreatment + hypoxia reoxygenation group (SP group) and sevoflurane combined with Compound C pretreatment + hypoxia reoxygenation group (ComC group), and the cell proliferation activity and apoptosis rate, myocardial enzyme levels in culture medium as well as the expression of apoptosis genes and p-AMPK in cells were determined. Results p-AMPK expression in cells of H/R group was significantly lower than that of C group, SP group was significantly higher than that of H/R group; cell proliferation activity value and Bcl-2 expression in cells of H/R group were significantly lower than those of C group, SP group were significantly higher than those of H/R group, ComC group were significantly lower than those of SP group; apoptosis rate, LDH, CK and AST levels as well as the Bax and Caspase-3 expression in cells of H/R group were significantly higher than those of C group, SP group were significantly lower than those of H/R group, ComC group were significantly higher than those of SP group. Conclusions Sevoflurane pretreatment can activate AMPK signaling pathway to inhibit the myocardial apoptosis caused by hypoxia reoxygenation.

Objective　To systematically evaluate the efficacy and safety of tirofiban for patients with acute ischemic stroke. Methods　Three electronic information sources （PubMed、EMBASE、Cochrane Library） were searched to identify relevant clinical studies on tirofiban in the treatment of people with acute ischemic stroke from initiation of the databases to August 31，2019.The reviewers extracted the data and assessed the quality of included studies，then meta-analysis is performed by RevMan 5.3 software. Results　We included twelve trials involving 2137 participants. The trial group had 921 patients，the control group had 1216 patients. The patients in trial group had lower NHISS scorce at 2～7 days after the therapy of tirofiban ［Mean Difference（MD）=-1.53，95% Confidence Interval（CI） -2.98～-0.09，P=0.04］.The use of tirofiban could increase the proportion of 90-day favorite outcome of AIS patients significantly，but did not improve the condition of recanalization of the blood vessels in 24 hours after the therapy of tirofiban. At the same time，tirofiban significantly reduced the 90-day mortality （RR=0.79，95%CI 0.65～0.97，P=0.02），and did not increase the intracranial hemorrhage rate （intracranial hemorraghic transformation：RR=0.89，95%CI 0.77～1.03，P=0.11；symptomatic intracranial hemorrhage：RR=0.93，95%CI 0.70～1.25，P=0.64）. Conclusion　Tirofiban administration is safe in patients with AIS，and can significantly improve the symptoms of early neurological impairment，a good prognosis at 90 days，and can reduce the risk of death at 90 days. But it does not improve the vascular recanalization within 24 hours treatment.

OBJECTIVETo explore the main points of clinical differentiation between hemangioma and vascular malformation in infant.

METHODSBased on Mulliken and Waner's classification, from March, 1997 to February, 1999, 81 baby patients with hemangioma were included in this study. Thirty-eight cases, 43 cases received medical treatment of steroids.

RESULTSAll the patients were followed up from 5 to 7 years. Thirty-eight cases of red strawberry-like lesions limited in the skin began to involute within two years old. Of the 30 patients with strawberry-like lesions and subcutaneous mass, 20 cases involuted in varying degree; 10 cases' subcutaneous mass grew gradually and didn't involute, in 4 cases biopsy was performed, 3 cases were confirmed as hemangioma accompanied with venous malformation by pathology, 1 case was hemangioma accompanied with arteriovenous malformation. Of 13 cases with light blue or normal skin and subcutaneous mass, 7 cases involuted in varying degree; 6 cases grow gradually and didn't disappear, 2 cases were confirmed as venous malformation by biopsy.

CONCLUSIONSHemangioma in infant begins to involute within two years old. Vascular malformation or hemangioma with deep vascular malformation grows persistently and does not disappear. Skin temperature of lesion surface and dilative veins on the skin artery pulsation, are indexes compressibility, for differentiation between hemangioma and vascular malformation in clinical diagnosis.

Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioma ; diagnosis ; Humans ; Infant ; Male ; Vascular Malformations ; diagnosis

OBJECTIVETo explore the clinical classification and ideal therapy for maxillofacial AVMs.

METHODSAccording to the clinical characteristics, 106 patients with maxillofacial AVMs were divided into the 4 types Of them, 38 cases were cystic dilatation lesions, 22 cases were limited thicken lesions, 42 case were diffuse thicken lesions, 4 cases were central maxillary hemangioma. 106 patients with maxillofacial AVMs were treated in our hospital, of them, 8 cases received operation (group 1); 23 cases received embolization of supplying artery alone (group 2); 37 cases received embolization of supplying artery plus hardener intra-tumorous injection (group 3); 38 cases received embolization of supplying artery plus tumor resection (group 4).

RESULTSOf all the patients were followed up 1 - 11 years, In group 1, 2, 3, and 4, the cure rates is 62.50%, 17.39%, 89.19%, and 97.37% respectively. one patient died of embolization of abnormal communication branches between external carotid and intra-cranical arteries.

CONCLUSIONS(1) This new clinical classification is beneficial for selecting method of treatment. (2) It is necessary that a good digital subtraction angiography for maxillofacial AVMs. (3) The embolization of tumor supplying artery alone could cure the small AVM with single branch terminal blood supply. (4) The embolization of supplying artery plus hardener intratumorous injection or the embolization of supplying artery plus tumor resection is an effective method for maxillofacial AVMs.

Adolescent ; Adult ; Angiography, Digital Subtraction ; Arteriovenous Malformations ; diagnosis ; therapy ; Carotid Artery, External ; diagnostic imaging ; Child ; Child, Preschool ; Embolization, Therapeutic ; methods ; Female ; Follow-Up Studies ; Humans ; Jaw ; blood supply ; Male ; Middle Aged ; Mouth ; blood supply ; Sclerotherapy

OBJECTIVE: To explore the genetic basis for two patients from a family with BCL11A-related intellectual disability (BCL11A-ID). METHODS: Clinical data of the proband and her family members was analyzed. Chromosomal karyotyping analysis, trio-whole exome sequencing (trio-WES) and copy number variation sequencing (CNV-seq) were carried out. For the suspected genetic variants, Sanger sequencing was used to verify, and pathogenicity assessment was conducted. RESULTS: The proband and her mother both had intellectual and language impairment, and their fetal hemoglobin (HbF) was significantly elevated. A heterozygous c.1327_c.1328delTC (p.Ser443Hisfs*128) variant was found in exon 4 of the BCL11A gene by WES, which has resulted in truncated expression of the encoded protein, and Sanger sequencing has verified that the variant was inherited from the mother. The variant was not found in related databases. The variant was predicted as pathogenic according to the guidelines from the American College of Medical Genetics and Genomics (ACMG) (PVS1+PM2+PP1). No karyotypic abnormality was found in the proband, her parents and brother, and no pathogenic CNVs was found in the proband and her parents. CONCLUSION The c.1327_c.1328delTC (p.Ser443Hisfs*128) variant may underlay the BCL11A-ID in the proband and her mother. This de novo variant has expanded the mutational spectrum of the BCL11A gene.
Humans ; Male ; Female ; Intellectual Disability/genetics* ; DNA Copy Number Variations ; Pedigree ; Mutation ; Transcription Factors/genetics* ; Mothers ; Repressor Proteins/genetics*

OBJECTIVETo investigate the impact of sodium nitroprusside (a nitric oxide donor) in the ductus arteriosus in preterm rabbits on hydrogen sulfide (H(2)S)-cystathionine-γ-lyase (CSE) system.

METHODSFor 16 Japanese white rabbits pregnant for 21 days were randomly divided into four groups, each of the following groups had 4 rabbits: control group, intraperitoneal injection of sodium nitroprusside 1 mg/kg, 2.5 mg/kg, and 5.0 mg/kg groups. The rabbits in control group had a peritoneal puncture with a simple hollow needle, and those in the other groups were given corresponding dose of intraperitoneal injection of sodium nitroprusside at gestational age 23 and 25 days, respectively. At gestational age 26 days the fetuses of the pregnant rabbits were removed surgically, and 28 fetal rabbits were obtained from the control group, 27 from the sodium nitroprusside small dose group, 29 from the medium dose group, and 26 from the large dose group. The fetal heart blood sample of 1 ml was taken from each fetus, and immediately after sampling the arterial ductal tissues were dissected. Fetal rabbit plasma proteins hydrogen sulfide content was determined by using de-protein method, and real time quantitative RT-PCR was used for determination of arterial tissue CSE gene and western-blotting was used for measuring protein expression of CSE.

RESULTSIn control group hydrogen sulfide content of fetal rabbits plasma (55.68 ± 6.57) µmol/L and arterial tissue CSE mRNA expression was 1.07 ± 4.12; the parameters in intraperitoneal injection of sodium nitroprusside group 1 mg/kg were (60.02 ± 6.09) µmol/L and 3.46 ± 0.18; in intraperitoneal injection of sodium nitroprusside group 2.5 mg/kg, were (64.71 ± 7.12) µmol/L and 10.95 ± 0.22; and in intraperitoneal injection of sodium nitroprusside group 1 mg/kg were (70.63 ± 8.07) µmol/L and 19.56 ± 0.17. Comparison between small dose group and control group, medium dose group and small dose group, high dose group and medium dose group showed that the above data were significantly different P < 0.05, with the injection of sodium nitroprusside CSE protein expression increased gradually with increasing doses.

CONCLUSIONSodium nitroprusside showed an enhancing effect on preterm CSE-H(2)S system in rabbit ductus arteriosus in a certain range of concentration in a dose-dependent manner.

Animals ; Cystathionine gamma-Lyase ; blood ; Ductus Arteriosus ; metabolism ; Female ; Hydrogen Sulfide ; blood ; Nitric Oxide ; blood ; Nitroprusside ; administration & dosage ; pharmacology ; Pregnancy ; Rabbits

OBJECTIVE: To analyze the clinical phenotype and genetic etiology for a child featuring congenital hypothyroidism (CH). METHODS: Whole exome sequencing (WES), copy number variation (CNV) sequencing and chromosomal microarray analysis (CMA) were carried out for a newborn infant who had presented at Linyi People's Hospital for CH. Clinical data of the child was analyzed, in addition with a literature review. RESULTS: The main characteristics of the newborn infant had included peculiar face, vulvar edema, hypotonia, psychomotor retardation, recurrent respiratory tract infection with laryngeal wheezing and feeding difficulties. Laboratory test indicated hypothyroidism. WES suggested a CNV deletion on chromosome 14q12q13. CMA further confirmed a 4.12 Mb deletion at chromosome 14q12q13.3 (32649595_36769800), which has encompassed 22 genes including NKX2-1, the pathogenic gene for CH. The same deletion was found in neither of her parents. CONCLUSION Through the analysis of clinical phenotype and genetic variant, the child was diagnosed with 14q12q13.3 microdeletion syndrome.
Female ; Humans ; Congenital Hypothyroidism/genetics* ; DNA Copy Number Variations ; Phenotype ; Syndrome ; Microarray Analysis

Telocytes are novel interstitial cells with a specific structure:the body has an elliptical shape or a triangle shape,with slender and thin protrusions that connect with other cells to form a complex 3D network.This article summarizes the structural characteristics and identification Methods of Telocytes and demonstrates their potential functions as a new target for disease prevention and treatment.
Telocytes

OBJECTIVE:To investigate the effects of WeChat platform online service on the safety of pediatric family medica-tion and the quality of pharmaceutical care. METHODS:The online consultation records of"Qs and As for pediatric medications"were collected and summarized from the WeChat platform(WeChat ID:etyywd)during Jun.1st,2014-Dec.31st,2015 in our hos-pital. Statistical analysis was performed on the consulting time periods,age of pediatric patients with consultation demands,and the systems and mistake types involved in medication consultations. RESULTS:A total of 29 850 dialogue records on WeChat were collected,and 13 315 of these were related to medications(44.61%). The peak time of medication consultation was at 9:00-10:00 in the morning,with an accumulative consultation number of 1 840 cases(13.82%);while the least consultation time pe-riod was at 4:00-5:00 early in the morning,with only 13 cases(0.10%).Pediatric patients in need of consultation were more with-in the age of 1-6 years old,and most of them were preschool children(31.20%)and toddlers(26.32%). The systems consulted mainly involved the respiratory system,immune system and digestive system;in which respiratory system had the most cases (60.28%). There were 1 508 Qs and As records for medication mistakes that were occured or may occure and were corrected in time(11.33%),in which the mistake types were mainly the unsuitable use of antipyretics(3.91%),antibiotics abuse(3.14%), careless use of combination medication and excessive medication(3.04%),excessively large or small doses(0.69%),improper use of nebulized inhalant after discharge(0.41%),and excessive use of vitamins(0.14%). CONCLUSIONS:The WeChat plat-form expands the service scope of clinical pharmacists.As an extension of hospital pharmaceutical care,it reduces the risk of fami-ly medication mistakes due to a patient's or members'wrong recognition to a certain degree,reinforces communication between doctors and patients,and improves the experience of medical services.