Objective To explore the clinical characteristic of lab results and prognosis of severe intestinal virus infection dis -ease and to provide the objective basis for early intervention .Methods All children who were admitted in pediatric intensive care unit ( PICU) by laboratory diagnosis as cases of severe intestinal virus infection disease in Hunan Children 's Hospital from January 6 to No-vember 25, 2010 were selected as cases of this study .Their medical records were collected .The data was analyzed by χ2 test, Fisher's exact test , and binary logistic regression .Results A percentage ( 33.1%) of patients had abnormal white blood cell ( WBC ) counts, and the difference rates of younger group (under 1 year old) and upper 5 years old group were higher than that in 1~5 years old group with statistically significance (χ2 =12.13, P <0.01).The difference rates of aspartate aminotransferase (AST) and cardiac troponin I(cTnT) were 23.8%and 31.5%, respectively.A percentage (52.9%) of patients had reduced CD4 lymphocytes.Abnor-mal WBC, C reactive protein (CRP), and prognosis have no significant difference ( P >0.05).There were statistically significant differences in procalcitonin (PCT), AST, cTnT anomalies and prognosis ( P <0.01 or P <0.05).Conclusions Abnormal PCT, AST and cTnT are associated with the prognosis of children with severe intestinal virus infection , while WBC and CRP are not .

The hypoxia-inducible factor-1(HIF-1) gene located on the long (q)arm 21-24 of chromosome 14, is composed of HIF-1? and HIF-1? subunits. HIF-1 promotes its target gene HRE to transcribe by binding to the element and then causes a series of responses of the cell to hypoxia. HIF-1 has been found to be overexpressed in breast cancer cell, and the expressions of HIF-1 level were correlated with the prognosis and prediction factors of breast cancer. As a cytokine, HIF-1 will be a new prognosis factor and a new target for the treatment of breast cancer.

Objective:To study the changes of endothelin-1(ET-1) and malondialdehyde (MDA) in Kawasaki disease (KD) and to probe the relationship between the changes of ET-1, MDA and coronary artery pathological changes. Methods: KD group included 42 patients ( male 25, female 17), with a mean age of (3.25?0.75) years old; control group included 30 normal children (male 19, female 11), with a mean age of (3.58?0.55) years old. Serum contents of ET-1 and MDA were measured by radioimmunology and modified thiabarbituricaid(TBA) method in 2 groups, and the inner diameters of coronary artery and aorta were measured by color echocardiography. KD group was subdivided into dilated-coronary artery group and undilated group for comparison.Results: Serum contents of ET-1 and MDA in KD group were apparently higher than those in control group (-[76.63?18.36-] vs -[41.55?16.68-] pg/ml and -[3.18?0.60-] vs -[1.52?0.24-] ?mol/L,respectively;P

Epithelial-mesenchymal-transition(EMT) plays a key role in the formation of embryo.At present,it is believed that EMT also contribute to the metastasis of primary tumors.A lot of signaling pathways participate in EMT,such as Wnt/?-catenin,Notch,Hedgehog,TGF? and growth factor receptors.The drugs that affect these pathways may play an important part in oncotherapy.

Objective To establish a specific,sensitive and applied method for the detection and differentiation of dengue virus types Ⅰ-Ⅳ,Japanese encephalitis virus and yellow fever virus.Methods Based on the genomes sequence analysis,6 pairs of primers were designed.The special capture probes of dengue virus types Ⅰ-Ⅳ,Japanese encephalitis virus and yellow fever virus were amplified,cloned and sequenced.Then the microwell plates were precoated using these capture probes,and the forward primers were labeled using biotin.The samples were then amplified using the biotin labeled forward primers and reward primers.The microwell plate hybridization was processed for detecting and differentiating the virus.The precoated DNA concentration,precoated time,hybridization temperature and hybridization time were optimized carefully.Results The A value of positive samples were over 0.5,while the average A value of the negative samples was less than 0.1.The S/N value exceeded 10.0.Sensitivity experiment suggested the method of PCR-ELISA could detect the virus RNA in 107 times dilution,while RT-PCR could detect the virus RNA in only 106 times dilution.The stability experiment of PCR-ELISA using DVⅠ suggested that the within-batch coefficient of variation was 6.21%,the between-batch coefficient of variation was 9.92%;the within-batch coefficient of variation in negative control was 1.92%,and the between-batch coefficient of variation in negative control was 3.68%.No visible changes were found on the performance of the coated microwell plates when stored in 4℃for 6 monthes.Conclusion PCR-ELISA is a more sensitive and specific method than RT-PCR is in the early detection and type identification of dengue Ⅰ-Ⅳ types virus,Japanese encephalitis virus and yellow fever virus.

Objectives To study the roles of Th17 cells in peripheral blood and the serum level of IL-17 in children with acute respiratory syncytial virus (RSV) bronchiolitis. Methods A total of 28 children with RSV bronchiolitis were selected as bronchiolitis group, among whom twelve cases were assigned into severe group and sixteen cases were assigned into mild group according to the severity of illness. Twelve cases with acute asthma were selected as asthma group. Ten children without recent infection waiting for surgery were chosen as controls. The percentage of Th17 cells in peripheral blood was measured by lfow cytometry. The serum level of IL-17 was detected by ELISA. The association of severity of illness with the percentage of Th17 cells and the level of IL-17 was studied in children with acute RSV bronchiolitis. Results The serum level of IL-17 and the percentage of Th17 cells were signiifcantly higher in the severe bronchiolitis group than those in the control group and mild bronchiolitis group (P<0.05). However, there was no signiifcant difference between the severe bronchiolitis group and the asthma group (P>0.05). Conclusions The percentage of Th17 cells and serum level of IL-17 are increased in children with acute RSV bronchiolitis, and may be involved in the pathogenesis of RSV bronchiolitis. (J Clin Pediatr,2013,31(9):850-853)

Objective To analyze the clinical features and prognosis of hyperglycemia and the relationship between the blood glucose level and the severity of disease in critically ill children.Methods A total of 349 critically ill children admitted in Pediatric Intensive Care Unit (PICU) from November 2009 to April 2010 were restrospectively analyzed.According to the levels of venous blood glucose within 24 h after admission,they were divided into very high level group (blood glucose ≥11.1 mmol/L,n =67 ),slightly high level group (blood glucose 6.3-11.1 mmol/L,n =134) and normal level group (blood glucose ≤6.3mmol/L,n =148).Blood glucose levels were measured within 24 hours,3 days and 7 days after admission.Electrolytes,inflammatory markers,cardiac enzymes,liver and kidney function as well as other biomarkers related to the severity and the prognosis of the patients were recorded after admission.The categorical variables were analyzed with Chi -squared test,the continuous variables were analyzed with t-test,F-test,U-test andH-test,and the correlation analysis was calculated by using Pearson Coefficients. Results In the very high level group,slightly high level group and normal level group,the average blood glucose levels were 16.98 ±7.08 mmol/L,8.25 ± 1.40 mmol/L and 4.89 ± 0.98 mmol/L ( P ＜ 0.01 ),respectively;and the Pediatric Critical Ⅲ Scores at admission were 81.22 ± 8.25,86.71 ± 6.40 and 86.15 ± 6.99 ( P ＜0.01 ),respectively,and the incidences of sepsis or septic shock were 55.23％,30.59％ and 14.18％,respectively (P ＜0.01 ),and the incidences of MODS were 46.26％,22.39％ and 16.23％,respectively (P ＜0.01 ).The blood glucose levels of patients with one organ failure and two organ failure were 8.27 ± 3.75 mmol/L and 8.88 ± 5.42 mmol/L,respectively ( P ＜ 0.05 ).The blood glucose levels of patients with two organ failure and multiple organ failure were 8.88 ± 5.42 mmol/L and 13.09 ± 8.23 mmol/L,respectively (P＜0.01).The mortality rates of three groups were 47.76％,14.93％ and 10.13％ (P ＜0.01 ),and the blood glucose levels at admission in survival group and death group were 7.57 ±4.11 mmol/L and 12.46 ± 8.17 mmol/L ( P ＜ 0.01 ).Conclusions Patients with hyperglycemia are often found in the PICU.It not only partially reflects the severity of the disease,but also serves as an important indicator for the prognosis.The blood glucose level is positively correlated to the number of compromised organs and the severity of the disease.Dynamic monitoring of blood glucose may be essential for controlling the symptoms and prediction of prognosis.

Objective To investigate the infection status and clinical features of common viruses in acute lower respiratory infection (ALRI) among the hospitalized children 0 to 7 years old in Nantong of Jiangsu.Methods 1 376 swab samples from pharynx nasalis in the ALRI inpatients 0 to 7 years old were collected.The human respiratory syncytial virus (RSV),adenovirus (ADV),influenza virusA,B (IVA,B),parainfluenza virus Ⅰ ～ Ⅲ (PIV Ⅰ ～ Ⅲ)were detected by direct immunofluorescence assay,and the results were analyzed.Results In 1 376 respiratory tract samples,there were 577 cases(41.93％) of positive samples.In all positive samples,there were 376 cases of RSVpositive (65.16％),42 ADV-positive (7.28％),63 IVA-positive (10.92％),24 IVB-positive (4.16％),20 PIV Ⅰ-positive(3.47％),19 PIV Ⅱ-positive (3.29％),108 PIV Ⅲ-positive (18.72％),68 cases with mixed infection (11.79％) [two virus-positive ones in 59 cases (86.76％),three virus-positive ones in 9 cases (13.24％)].In different age group,the highest positive rate was in 0 ～ 6-month-old group(53.32％),with the lowest in 5-7 years old group(6.90％).Virus detection rate was higher in March 2012 (58.67％),December 2012 (53.33％),and January 2013(53.63％)than the rest months,including the lowest June 2012(33.33％).Bronchiolitis virus detection rate was the highest(69.23％)among ALRI.Conclusion The virus is major pathogen of children 0 to 7 years old with ALRI in Nantong of Jiangsu,and with difference among different ages,seasons and diseases.Infants and young children are the main affected population.

Objective To explore the protective effect of L-carnitine on neonates with myocardial injury caused by as?phyxia. Methods Forty-four neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group (21 cases) and control group (23 cases). Patients in control group were received routine treatment and pa?tients in treatment group were given L-carnitine 0. 1 g/(kg · d) on the basis of routine treatment for 7 days. Symptoms and physical signs were observed before therapy and during the treatment in two groups. Before and after the treatment, plasma levels of free L-carnitine and cardiac troponin I (cTnI) were detected with the method of colorimetric assay and chemilumi?nescent, respectively. Results The clinical effective rate was significantly higher in treatment group than that of control group (90.48%vs 60.87%, P<0. 05). Compared with the control group, there was a significantly higher plasma concentra?tion of free L-carnitine in treatment group after treatment [(27.00±5.69)μmol/L vs (13.20±3.04)μmol/L, P<0.05]. In treat?ment group, plasma concentration of free L-carnitine was significantly higher after treatment than that of pre-therapy [(14.87 ± 3.95)μmol/L,P<0.05]. Compared with the control group, there was a significantly lower plasma concentration of cTnI after treatment in treatment group [(0.025±0.006)μg/L vs (0.046±0.010)μg/L, P<0.05]. In the treatment group, there was a significant correlation between decreased plasma concentration of cTnI and increased plasma concentration of free L-carnitine (r=0.899, P<0.05). Conclusion Administration of L-carnitine can effectively decrease the abnormal plasma lev?el of cTnI in neonates with myocardial injury caused by asphyxia, and thereby protect the myocardium.