Syncope and epilepsy are common pediatric clinical symptoms and causes of paroxysmal loss of consciousness.They can be manifested as a sudden attack,transient and reversible loss of consciousness,easily leading to misdiagnosis in clinics.The etiology and pathogenesis of syncope and epilepsy are completely different,and the principle of treatment is also different.Therefore,in clinics,making an early diagnosis and differential diagnosis between syncope and epilepsy has an important significance to improve the treatment and the prognosis of the patients.

BACKGROUND: Rheumatoid arthritis(RA) is an autoallergic disease,but its immunological pathogenesis has not been completely known. T lymphocytes, especially CD4+ TH1/TH2 cells, may have an important effect in the occurrence and development of RA.OBJECTIVE: To investigate the action of CD4+ TH1 and TH2 cells which separately mediate cellular immunity and humoral immunologic response (respectively) function in the occurrence and development of RA.DESIGN: Case-control, comparative observation.SETTING: Department of Immunology, Medical College of Chinese People's Armed Police Forces.PARTICIPANTS: Totally 15 patients with RA hospitalized in the Department of Internal Medicine of General Hospital of Tianjin Medical University between March 1999 and March 2000 were selected for a RA patient group, consisting of 2 males and 13 females. Of them, 12 patients whose serumal rheumatoid factor (RF)was positive and the three others' was negative. At the same time, 30 healthy individuals from persons receiving health examination in the hospital or from our department were selected for a healthy control group, consisting of 4 males and 26 females. Informed consents were obtained from the participants.peripheral blood mononuclear cells(PBMC) from the two groups of subjects were detected by enzyme-linked immunospot assay (ELISPOT). 200-500 lymphocytes were counted under a normal light microscope, and the perwhich secreted cytokines were detected by ELISPOT, and those which had red spots in their plasma after staining were positive cells. Among them,the cells secreting γ-interferon (IFN-γ) were Tm cells while those secreting interleukin-4 (IL-4) were TH2 cells. 200-500 lymphocytes were counted under a normal light microscope and the percentages of TH1 and TH2 cells square test were used for comparing statistical differences of data between the two groups.MAIN OUTCOME MEASURES: Quantitative analysis of T lymphocyte subsets (including CD3+ T cells, CD4+ T cells and CD8+ T cells) and CD4+ TH1/TH2 cells in peripheral blood from the two groups of subjects.RESULTS: Analysis of the results was from the study on all of subjects percentages of total T cells (CD3+ T cells), CD4+T cells and CD8+F cells in peripheral blood were not significantly different between the two significantly higher in RA patient group than that in healthy control group [(24.44±5.25)%, (14.93±3.82)%, P ＜ 0.05],while in RA patient group the percentage of TH2 cells and ratio of TH1 cells to TH2 cells from peripheral blood were not significantly different as compared with those of control group(P ＞ 0.05).CONCLUSION: Cellular immunologic function mediated by TH1 cells may be associated with the occurrence and development of RA.

Objective To study the trend of antimicrobial resistance to cnical isolates of Klebsiella pneumoniae and Escherichia coli.Methods VITEK-32 automated analysis system was used for bacteria differentiation and drug resistance determination.Results TS From 2005 to 2008,the prevalence of ESBLs in isolates of K.pneumoniae and E.coil were increasing,their were 36.6% ,40.6% ,41.5% ,41.0% each year separately.The ESBLs-producing bacteria,multiple-drug-resistant to the third generation cephalesporin,aminoglycosides,quinolones and sulfonamides were also increased.Conclusion There is an increasing trend of ESBLs produces and resistences in K.pneumoniae and E.coli,It is important for clinical physicians to understand the distribution and the resistance characteristics of ESBLs producing K.pneumoniae and E.coli were to antibiotics,and to control the ESBLs spread.

Objective To investigate the relationship between occurrence of unexplained recurrent spontaneous abortion(URSA) and immune function of T lymphocytes. Methods T lymphocyte subsets and CD + 4 T helper subsets (including T helper 1 and T helper 2 cells) in peripheral blood from 30 cases with URSA and 24 healthy women (controls) were detected by enzyme-linked immunospot assay (ELISPOT). Results The percentage of CD + 4 positive T lymphocytes in URSA group was higher than that in the controls (60% vs 45%, P

Objective To investigate the expression of caspase-3 and FasL in the hippocampus of the infantile rats with recurrent sei-zures. Methods 72 of 20-day-old Sprague-Dawley rats were randomly divided into two groups, control group and seizure group. Seizures in rats were induced by inhalant flurothyl daily in six consecutive days. Brain tissue was sampled at different time points (the 1st day, 3rd day and 7th day) after last seizure. The expressions of caspase-3 and FasL proteins in the hippocampus were detected by immunohistochemistry, and the expression of caspase-3 mRNA was measured by reverse transcription- polymerase chain reaction (RT-PCR). Results The caspase-3 protein, FasL protein and caspnse-3 mRNA levels were obviously increased at the 1st, 3rd and 7th day after recurrent seizure in the hippocampus of the rat(P<0.01). Conclusions Caspase-3 and FasL are participated in the infantile brain injury after recurrent seizures.

Objective: To investigate the expression of caspase1 mRNA in hippocampus of(developing) rats following recurrent seizures and the effects of tetramethylpyrazine on it.Methods: One(hundred) and(sixty)two postnatal SpragueDawley rats of 20day old were randomly divided into three groups: the control group,the seizure group and the tetramethylpyrazine treated group.Seizure model of rats were induced by(inhalant) flurothyl daily in 6 consecutive days.Brain tissue was sampled at 6 hours,1 day,(3 days) and 7 days in each group after last seizure,and the expression of caspase1 mRNA in the hippocampus was(detected) by(reverse) transcriptionpolymerase chain reaction(RTPCR).At the same time,the water content was(detected) and the pathological changes in the hippocampus of rats were observed after recurrent seizures and the brain injury was evaluated by using a semiquantitative neuropathological scoring system.Results: In(tetramethylpyrazine) treated group,the levels of caspase1 mRNA in the hippocampus,water content of brain tissues and neuropathological score at different time points were obviously lower than those in seizure group(except water content of brain tissues at 7 days,all P

Objective To investigate the effects of Ginkgo biloba(银杏叶) extract on the expression of caspase-3 in the hippocampus of the rats following recurrent seizures,the role of caspase-3 in the brain injury induced by seizures and the possible protective mechanism of Ginkgo biloba extract against brain injury.Methods One hundred and eight Sprague-Dawley(SD) rats,twenty-day-old,were divided randomly into three groups: the control group,the seizure group and the Ginkgo biloba extract treatment group.Seizures models in rats were produced by consecutive inhalation of flurothyl daily for six days.The rats in the Ginkgo biloba extract treatment group received 50 mg/kg of the Ginkgo biloba extract through intra-abdominal injection immediately after every seizure,and after 12 hours another injection was repeated,while the rats in seizure group and control group received volume-matched saline through intra-abdominal injections.Brain tissue was sampled at different time points(1 day,3 days,7 days) after last seizure.The expression of caspase-3 protein in the hippocampus was detected by immunohistochemistry,and the expression of caspase-3 mRNA was measured by reverse transcription-polymerase chain reaction(RT-PCR).Results The caspase-3 protein and caspase-3 mRNA levels at the time points of postseizure 1,3,7 days in the hippocampus of the rat pups in seizure group were much higher than those in control group,while they were highest on the post-seizure 3rd day(all P

5 cases diagnosed with Dandy-Walker Syndrome from May 2006 to November 2009 were investigated and relevant literature reviewed. Dandy-Walker Syndrome was characterized by retarded motordevelopment and cerebellar signs. The latter was observed in 3 cases in our series. The disorder, mostly influencing childhood, typically causes the fourth ventricle enlarged, and the cauda cerebelli atrophic or even absent. MRI is the most optimal radiological method to diagnose it.

The practice operation is an important method of clinical pediatric teaching during internship.We should fully consider the application occasions and select the most appropriate teaching cases when using this method on the clinical application teaching.The preparation before the intern should be emphasized because it is one of keys for students to learn much in the application.In order to correctly evaluate the effects of practice operation,we must focus on testing the working ability of students and standardizing the examination.

Objective To evaluate the effects of unilastatin on brain injury in children undergoing aortic arch surgery under cardiopulmonary bypass (CPB).Methods Twenty ASA physical status Ⅲ or Ⅳ children of both sexes,aged 1-24 months,weighing 3-12 kg,undergoing repair of coarctation of aorta or interrupted aortic arch complicated with intracardiac malformations under CPB,were randomly divided into 2 groups (n =10 each):control group (group C) and ulinastatin group (group U).Ulinastatin 20 000 U/kg was diluted into 10 000 U/ml with normal saline and it was then injected intravenously in 3 parts (1/3 was injected via the internal jugular vein after induction of anesthesia; 1/3 at the beginning of CPB and 1/3 at 5 min before aortic unclamping).In group C the equal volume of normal saline was given instead of ulinastatin.Blood samples were taken from the radial artery after induction of anesthesia (T1),at 10 min after aortic clamping (T2),at 10 min after aortic unclamping (T3),at the end of CPB (T4),and at 6 and 24 h after termination of CPB (T5,T6) for determination of plasma S100B protein and neuron-specific enolase (NSE) concentrations.Results There was no significant difference in plasma levels of S100B protein and NSE at T1 between the two groups (P ＞ 0.05).Plasma S100B protein and NSE levels were significantly increased at T2-5 as compared to the baseline values at T1 in both groups (P ＜ 0.05).Plasma S100B protein and NSE levels were significantly lower at T2-5 in group U than in group C (P ＜ 0.05).Conclusion Ulinastatin can attenuate brain injury in children undergoing aortic arch surgery under CPB.