Abstact:Objective To investigate the clinical value of mean platelet mass(MPM)and the procalcitonin(PCT)in diagnosis of Kawasaki disease (KD).Methods A Total of 117 children with KD in the acute stage and 126 children of the control group were detected respectively and compared each other.The indexes contain MPM,PLT,MPV,PDW and PCT.Mean-while,the comparison of each index’s positive rate and the linear correlation analysis of each index were conducted.Results①The level of MPM of the KD group was significant lower than that of the control group,PLT,MPV and PCT significant higher than those (P<0.05,α=0.05).The difference of PDW between the two groups was no statistical significance (P>0.05,α=0.05).②The positive rate of the MPM was significant higher than that of the other indexes (P<0.05,α=0.05). Conclusion The detection of MPM is helpful to the diagnosis of KD and can be used as an indicator of KD clinically.

Objective To explore the clinical manifestations and recovery from neuroimaging abnormalities of acute disseminated encephalomyelitis (ADEM),in order to improve the understanding of ADEM.Methods A total of 47 children with ADEM in Department of Neurology,Children′s Hospital of Soochow University were followed up for 1 year.The clinical manifestations,auxiliary examination (especially neuroimaging),treatment and prognosis were analyzed.The recovery conditions from clinical and neuroimaging abnormalities were summarized.Results Among 47 cases,37 cases (78.72%) had prodromic infection history,and 5 cases (10.64%) had the history of vaccination.The clinical manifestations were varied,including 36 cases (76.60%) with somatic discomfort,30 cases (63.83%) with fever,30 cases (63.83%) with disturbance of consciousness,28 cases (59.57%) with epileptic seizure,24 cases (51.06%) with headache and dizziness,22 cases (46.81%) with nausea and vomiting,15 cases (31.91%) with dyskinesia,15 cases (31.91%) with cranial nerve injury,9 cases (19.14%) with incoordination,and 8 cases (17.02%) with mental and behavior disorders.Abnormal lesions presented multiple,asymmetric patchy and large patchy signal image showed by brain magnetic resonance imaging (MRI),and 7 cases (14.89%) involved the spinal cord.All patients received the treatment of Methylprednisolone [15-20 mg/(kg·d)] combined with intravenous gamma globulin (total 2 g/kg,3 to 5 days).The dose of Methylprednisolone gradually decreased after it had been used for 3 days.In the end,it was replaced by an oral administration of Prednisone [1.0-2.0 mg/(kg·d)],and the total treatment period was for 2-3 months.The follow-ups of 47 children with ADEM showed that the MRI lesions of all the children were reduced and the MRI lesions in 4 (8.51%) of them disappeared completely after 0.5 month of follow-up;the lesions disappeared completely in 13 cases (27.66%) after 1 month of follow-up;the lesions disappeared completely in 23 cases (48.94%) after 3 months of follow-up;the lesions disappeared completely in 32 cases (68.09%) after 6 months of follow-up;the lesions disappeared completely in 43 cases (91.49%) after 1 year of follow-up;and finally there were 4 cases (8.51%) with residual lesions.Conclusion The clinical manifestations of children with ADEM are varied.Most children with ADEM have a favorable prognosis.Imaging lesions of 68.09% of the cases completely disappeared after the onset of 6 months.Imaging lesions in 91.49% of the cases completely disa-ppeared at the onset of 1 year.Only a small fraction of patients present permanent lesions.

Objective To investigate the level of 25-hydroxyvitamin D[25(OH)D]and relationship to C-reactive protein(CRP) and procalcitonin(PCT)in children with severe pneumonia.Methods Serum 25 (OH)D levels of 86 cases of children with severe pneumonia,81 cases of children with mild pneumonia and 85 cases of children in healthy control group on admission were deter-mined by ELISA respectively and compared.At the same time,CRP and PCT were tested and the correlation to 25(OH)D in chil-dren with severe pneumonia was analyzed.Results There are statistical differences among three groups(P <0.05,α=0.05 ).The mean values of serum 25 (OH)D were (62.03 ±17.94),(68.90 ±15.22)and (82.21 ±17.89)μmol/L in severe pneumonia pa-tients,mild pneumonia patients and healthy children respectively,furthermore,prevalence of vitamin D deficiency of the sever pneu-monia group was significantly higher than that of the case-control group and normal group (P < 0.05,α= 0.05 ).The level of 25(OH)D was not significantly related to CRP and PCT level in children with severe pneumonia(P <0.05,α=0.05).Conclusion The mean level of vitamin D in children with severe pneumonia was significantly lower,which may be associated with the occurrence and develop-ment of severe pneumonia in children.

Objective To analyze the dose rate effect and potentially lethal damage repair in DNA double strand break repair deficient murine cells (SCID) irradiated by ? ray. Methods The wild type(CB.17+/+) and SCID cells were exposed to ? ray at high and low dose rates. The high dose rate exposure was fractionated into two equal doses at 24?h intervals. The survival rates of irradiated cells were calculated by clony forming analysis. Results When ? ray was given to wild type(CB.17+/+) cells in two fractions at 24?h intervals, the survival rate was significantly higher than that when the same total dose was given singly. In contrast, there was no difference in the survival rates between the single and fractionated exposure in SCID cells. SCID cells were more sensitive than CB.17+/+ cells to both low and high dose rates ? ray exposure for cell killing. The survival rate by low dose rate exposure was significantly higher than that by high dose rate exposure, not only in CB.17+/+ cells but also in SCID cells. Conclusions SCID cells are deficient in repairing ? ray induced double strand breaks. There is dose rate effect in both SCID and CB.17+/+ cells.

Objective:To explore the role of lectin-like oxidized low density lipoprotein (ox-LDL) receptor(LOX1) in ox-LDL stimulating endothelial nitric oxide(NO) production. Methods: LOX1 mRNA expression was detected by reverse transcription-polymerase chain reaction(RT-PCR). The quantity of NO was detected by Enzyme-method. Results: Incubation of ox-LDL increased endothelial NO production and LOX1 mRNA expression. When HUVECs were incubated with ox-LDL as well as the inhibitor of LOX1, polyinosinic acid,the increase of NO production and LOX1mRNA expression were attenuated. Conclusion: Ox-LDL enhanced endothelial NO production in a concentration-dependent manner, and the effect of ox-LDL on endothelial NO was mediated by LOX1.

Objective To study the hemodynamic characteristics of ductus venosus,and its relationship to inflammatory cytokines in ovine fetus with systemic inflammatory response syndrome.Methods Ten near-term fetal sheep radomly divided into two groups.Five of them were in experimental group,and five of them were in control group.All of the animals underwent abdominal cordocentesis guided by ultrasound at the term of 120-130 days,with a LPS injection at a dosage of 10 μg/kg of fetal weight in experimental group,and the same quantity of 0.9% NaCl solution in control.Doppler echocardiography were performed to determine hemodynamics changes of ductus venosus at 0.5 hour before the LPS injection,and at 1 hour,3 hours,6 hours after LPS injection.Meanwhile,fetal umbilical vein blood was sampled for ELISA essay of serum TNF-α and IL-6 at each of the above time points.Results In experimental group,the ductus venosus waveform PI values(DVPI),maximum velocity during cardiac ventricle systole(S)and during cardiac ventricle diastole(D),ductus venosus index(DVI),ductus venosus blood flow(DVQ),the ratio of S and ductus venous maximum velocity during atrial contracton(S/A),(S-A)/D increased with the time after LPS injection,and still significantly increased as compared with the control animals(all P＜0.05).A decreased with the time after LPS injection,and still significantly changed as compared with the controls(P＜0.05).And the ductus venosus diameter(DVD)had not obvious change(P＞0.05).There were significantly positive correlations between DVPI and TNF-α,IL-6(all P＜0.05),negative corelations between A and TNF-α,IL-6(all P＜0.05),and positive correlations between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and IL-6(all P＜0.05),but not obvious relationships between S wave,DVI,DVQ,D wave,S/A,(S-A)/D and TNF-a(all P＞0.05).Condusions DVPI and A might be easy and useful quantitative parameters in the evaluation of fetal systemic inflammatory respome syndrome with LPS injection.

Objective To explain the differences between zingiber officinale and its sulfur fumigation products on chromatography fingerprints by HPLC-DAD;To discuss the influence of sulfur-fumigation on the quality of zingiber officinale. Methods HPLC, diode array detector, and ZORBAX SB-C18 column were used with acetonitrile-water as the mobile phase, gradient elute, volume flow rate of 1 mL/min, column temperature of 25 ℃, and detection wavelength of 280 nm. HPLC-DAD technology was applied to establish the fingerprints of zingiber officinale before and after sulfur-fumigating process, in order to analyze the HPLC fingerprints of zingiber officinale before and after sulfur-fumigating process. External standard method was used to do the quantitative determination of 6-gingerol. Results The 17 common peaks were identified through the comparison of 3 batches of fingerprints of zingiber officinale and their sulfur-fumigated samples. The peak areas of NO.3, NO.10, NO.11, and NO.17 were reduced by 50.68%, 64.41%, 67.68%, and 21.23%respectively. The content of 6-gingerol had no significant change. Conclusion The chemical composition of zingiber officinale changed at different degrees after sulfur-fumigated process. The safety and effectiveness of sulfur fumigation products of zingiber officinale require more researches.

ObjectiveTo investigate the migration of bone marrow stem cells (BMSCs) to the liver and liver repair in mice with acute liver injury treated with BMSC transplantation through four approaches. MethodsMale BALB/c mice were divided into groups A, B, C, D, E, and F, with 10 mice in each group. Groups A, B, C, and D were treated by transplantation, group E was used as the donor of BMSCs, and group F was used as the model of acute liver injury. CCL4/2-AFF was used to establish the model of acute liver injury. Mouse BMSCs were isolated, labeled with the red fluorescent dye PKH26, and then transplanted into the mice with acute liver injury through the portal vein (group A), the tail vein (group B), the abdominal cavity (group C), and the spleen (group D). The mice were sacrificed 2 weeks later. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (Alb) were measured. The pathology of liver tissue was observed to evaluate the migration of BMSCs to the liver and the degree of liver repair. The mice in group F were sacrificed on day 8 to measure the levels of ALT, AST, and Alb. The t test was used for comparison of continuous data between two groups, and one-way analysis of variance was used for comparison of continuous data between multiple groups. ResultsIn groups A, B, C, and D, transplanted BMSCs migrated to the liver under a microscope, and newly formed hepatocytes were observed on pathological images. There were significant differences in the levels of ALT, AST, and Alb between groups A, B, C, and D and group F (ALT: t=2.372, 2.473, 2.354, and 2.383, all P＜0.05; AST: t=2.534, 2.423, 2.437, and 2.643, all P＜0.05; Alb: t=2.336, 2.243, 2.373, and 2.352, all P＜0.05). ConclusionBMSCs can promote repair of the liver in mice with acute liver injury, and the degree of liver repair is not related to the transplantation approach.

Objective To investigate the clinical value of plasmatic heparin-binding protein in early diagnosis and severity gradation of neonatal sepsis.Methods Thirty-nine patients with general sepsis,37 patients with severe sepsis and 16 patients with septic shock were recruited as corresponding study groups respectively,who all had been admitted to the Neonatal Intensive Care Units(NICU)of Hunan Children′s Hospital from December 2016 to August 2017,meanwhile,34 patients with local infection and 35 patients with non infection were enrolled as relevant control group respectively who all had been admitted to each neonatal ward in the retrospective study.The level of the heparin-binding protein(HBP), procalcitonin (PCT)and high sensitive C-reactive protein(hs-CRP)of all patients were detected respectively at the beginning of hospitalization.The difference of each group was compared by use of nonparametric statistics and the efficacy of every index on diagnosis of infection and sepsis was assessed with the receiver operating characteristic curve(ROC).Results The level of HBP in sepsis group,severe sepsis group and septic shock group HBP(H=91.764,P<0.01), PCT(H=51.757,P<0.01)and hs-CRP(H=28.418,P<0.01)are significantly higher than those in local infection group and non infection group;Plasmic HBP levels of severe sepsis group[52.35(33.65,88.15)(ng/ml)]and septic shock group[73.55(60.61,145.51)(ng/ml)]are statistically higher than general sepsis group[34.12(23.04,41.79)(ng/ml)](H=24.092, P<0.01).There are no statistically differences of serum PCT and hs-CRP among these three groups[(HPCT=1.909,Hhs-CRP=0.292),P>0.05].The area under the curve(AUC)of HBP in diagnosis of neonatal sepsis and infection are 0.885 and 0.904 respectively,more higher than PCT and hs-CRP;With the cut off value of 19.8 ng/ml,the sensitivity and specificity of HBP on diagnosis of infection are 85.7%and 82.9%respectively;the sensitivity and specificity 80.4% and 88.4% for neonatal sepsis with the cut-off value of 28.0 ng/ml respectively.Conclusion HBP probably has the better clinical value than PCT and hs-CRP in the early diagnosis and severity gradation of neonatal sepsis.

Objective To investigate the prevalence and characteristics of non-nucleoside reverse transcriptase inhibitors (NNRTIs)resistance-related gene mutations among the AIDS patients with virological suppression failure in Guangdong Province 2015.Methods Plasma samples from AIDS patients receiving highly active antiretroviral therapy for more than one year with viral loads > 1000 copies/mL from Guangdong province (except Shenzhen)were collected from January to December 2015.Total 612 HIV-1 gene fragments were amplified from plasma samples using self-developed lab method.Sub-genotypes were determined by phylogenetic tree according to the sequences,NNRTIs resistance-related mutations were determined in Stanford University HIV-1 Drug Resistance Database. The NNRTIs-resistance, the relationships of NNRTIs resistance-related mutations with baseline CD4 +T lymphocyte counts,transmission routes,antiviral regimens and HIV-1 genotypes were analyzed.SPSS 17.0 software was used to analyze the data.Results In 612 patients with virological suppression failure,the main NNRTIs resistance-related mutations were K103 (26.80%),Y181 (14.71 %),V179 (13.73%),G190 (11 .44%) and V106 (10.62%).The susceptibility rate of 310 patients (50.65%)to NNRTIs had changed,the highly resistant rate to nevirapine was 49.51 %,which was higher than that of efavirenz (43.14%),etravirine (5.56%) and rilpivirine (12.25%),respectively,and the differences were statistically significant (χ2 =5.00,296.3 and 198.0,all P <0.05).The incidence rate of drug resistance in patients with baseline CD4 +T lymphocyte counts >200 cells/μL was lower than that in those with baseline CD4 +T lymphocyte counts <200 cells/μL (χ2 =17.93,P <0.01 );the incidence rate of drug resistance was lower in intravenous drug abusers than that of sexually transmitted patients (χ2 =44.21 ,P <0.01 );while the incidence of drug resistance in patients receiving NVP-containing regimens was higher than that in those receiving EFV-containing regimens (χ2 =8.93,P <0.01 ),and the incidence rate was higher in patients with CRF01 _AE than that in those with CRF07_BC and CRF08 _BC (χ2 =8.46 and 8.47,P <0.01 ).Conclusions The results suggest that compliance education and follow-up should be strengthened in patients with high baseline CD4 +T lymphocyte counts and intravenous drug users,and patients with liver diseases should avoid using drugs containing NVP regimens.