Objective To study breathing characteristics of normal children of 6～7 years old when speaking in a normal manner.Methods RM 6240 physiological signal collection and processing system and Hx 100 respiratory transducer were used to collect the average peak expiratory pressure,inspiratory valley pressure,respiratory rate,respiratory depth from 160 normally speaking children.Results When speaking,the average peak expiratory pressure,inspiratory valley pressure,respiratory rate and respiratory depth of chest were all significantly increased (P<0.01);while that of abdomen was all reduced(P<0.05,P<0.01)except for respiratory rate(P<0.05)which was increased.In both respiratory conditions,all the data of abdomen were significantly larger than thaf of chest(P<0.01);all the data of boys were larger than that of girls(P<0.05,P<0.01).Conclusion When speaking,it involves thoraco-abdominal breathing,and the increase of chest activity will increase the volume of inhaled air.The increase of abdominal activity is for better control of respiratory airflow.Abdominal breathing plays a main role in normal speaking.Boys'respiratory muscles,respiratory organs are developed better than girls.

Objective To explore the serum levels changes of heart-type fatty acid-binding protein and brain natriuretic peptide in children with Kawasaki disease,as well as their links with the heart function. Methods A total of 53 children with Kawasaki disease admitted to our hospital from February 2008 to March 2012 were selected and at the same time 50 healthy controls were randomly selected. The serum levels for the children in acute phase,recovery period of Kawasaki disease and control group children were determined by en-zyme-linked immnoabsorbent assay. The internal diameter of coronary artery,LVEF,LVSF,CI and E/A of chil-dren were measured by two-dimensional echocardiography. Results The heart-type fatty acid-binding protein and brain natriuretic peptide concentrations of children with Kawasaki disease in acute stage[(18. 23 ± 13. 81) ng/ml,(517. 2 ±213. 2) pg/ml] were higher than those in recovery stage[(6. 29 ± 1. 26) ng/ml,(92. 1 ± 46. 0) pg/ml](P<0. 05). They were also higher for children in acute stage than those of control group[(6. 26 ± 1. 60) ng/ml,(37. 6 ± 7. 6) pg/ml]. The LVEF,LVSF,CI of Kawasaki disease for children in acute stage were lower than those in recovery phase[(60. 3 ± 3. 6)% vs. (64. 8 ± 4. 3)%,(30. 6 ± 2. 5)% vs. (34. 9 ± 1. 9)%,(3. 1 ± 0. 3)% vs. (3. 5 ± 0. 3)%]. Linear correlation analysis showed the heart-type fatty acid-binding protein and brain natriuretic peptide′concentrations in Kawasaki disease were negatively correlated with LVEF (P<0. 05). The heart-type fatty acid-binding protein′positive rates were also higher than brain natriuretic peptide for the children in acute and recovery phase. Conclusion The heart-type fatty acid-binding protein and brain na-triuretic peptide could be used as the biochemical markers for myocardial damage of children with Kawasaki dis-ease. The heart-type fatty acid-binding protein was more significant than brain natriuretic peptide. The heart-type fatty acid-binding protein and brain natriuretic peptide in Kawasaki disease were also high in recovery stage,indi-cating that myocardial damage could maintain for a long period after the clinical improvement.

Pulmonary hypertension is a group of diseases with high pressure of pulmonary circula-tion,severe cases can lead to increased right ventricular afterload,even right heart failure. Children pulmonary hypertension is difficult to detect in early stage because its nonspecific clinical manifestations. It is a serious complication of many respiratory diseases,it leads to decreased lung function and life quality. Screening early pulmonary hypertension of these children will facilitate it′s diagnosis,treatment and prognosis.

Secondary hyperparathyroidism (SHPT) is the common complication in chronic kidney disease patients,especially in those with hemodialysis,which is associated with cardiovascular events and mortality.Active vitamin D and its analogues are classic treatment for SHPT,but some patients are resistant to active vitamin D,and ablation would be a choice for such cases.The purpose of this review is to provide current progress in ablation for SHPT.

BACKGROUND: Carboxymethyl chitosan is a water-soluble derivate modified from chitosan, with various biological activities. It is a good ligand of metal ion and can integrate Ca~(2+) to prepare a novel biological material. OBJECTIVE: To explore a method for preparing carboxymethyl chitosan calcium (CCC) and analyze its properties and structure. METHODS: CCC was produced by carboxymethyl ohitosan reacting with solution of calcium chloride. The solubility, carboxymethylation degree, rotational viscosity, and calcium content of CCC were determined, and infrared and ultraviolet spectral analyses were performed.RESULTS AND CONCLUSION: The calcium content of CCC was approximately 15%. Compared with carboxymethyl chitosan, infrared spectrum and ultraviolet spectrum of CCC were changed. The prepared CCC is a new calcium compound through property and structural analysis.

Objective To observe the effect of carboxymethyl chitosan calcium(CCC) on the concentration of lead,calcium,and liver antioxidative capacity in lead poisoned mice.Methods mice were randomly divided into 6 groups.Three test groups were treated with CCC at three doses.The lead poisoned mice model was established by giving water containing lead acetate,and then CCC was administered to mice once a day.After 30 days,the mice were killed and the content of lead in blood,liver,brain and femur were determined by atomic absorption spectrophotometer,and antioxidative capacity in liver was measured using assay kit.Results CCC could reduce the contents of lead in blood,brain,liver and femur significantly,decrease the level of maleicdialdehyde(MDA),increase activities of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and total antioxidative capacity(T-AOC) in liver markedly. Conclusion CCC can promote the excretion of lead,increase the content of calcium in femur and antioxidative capacity in lead poisened mice.

Objective To study the adenovirus infection and popular features in hospitalized respira-tory infection children of Qingdao area. Methods A total of 6 820 cases of respiratory infection from March 2011 to February 2014 in our hospital were enrolled,the average age was 5 years and 2 months old. Their ve-nous serums were collected on the first day of hospitalization,adenovirus IgM was monitored by indirect im-munofluorescence application. The adenovirus-positive rates of cases between different age groups, seasons and diseases were observed. Results Adenovirus were positive in 1 043 children,the rate was 15. 29%. The positive rate of young children group(1-3 years old) was 16. 92%,which was highest,there was statistic difference between young children group and other age groups(χ2 =12. 50,P<0. 05). Adenovirus infection rates were upward in recent years,the infection rates of winter and spring were higher than those of summer and fall,and there were significant differences between them(χ2 =28. 89,P <0. 05). The positive rate of AdV-IgM in children with severe respiratory tract infection was higher[19. 90%(877/4 408)]than that of the children with mild infection[12. 27%(296/2 412)](χ2 =64. 25,P<0. 05). Conclusion In recent years, adenovirus infection rate in Qingdao hospitalized respiratory infection children was rising,the infection rates in winter and spring were high,young children were the most vulnerable populations. The positive rate of ade-novirus infection in children with severe respiratory tract infection is higher than that of the children with mild respiratory tract infection.

Objective To study the serum levels of brain natriuretic peptide (BNP) and the correlation with the heart function in children with Kawasaki disease(KD), and to explore its clinical value for diagnosis of KD. Method A total of 43 children aged from 5 months to 8 years with mean age of (2.3 + 0.6) years with KD admitted from February 2007 to April 2009 were enrolled into this study as KD group, and patients with myocarditis, myocardiopathy, congenital heart disease and other primary heart disease were ruled out. Another 30 healthy children were taken as control health group. There were no significant differences in age and gender between two groups (P >0.05) .The serum levels of BNP were measured both in acute and recovery stages of KD by using ELISA. The serum levels of BNP in healthy children were measured randomly once. The left ventricular ejection fraction (LVEF), left ventricular shorten fraction ( LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus (including E-velocity and A-velocity) were measured by using two-dimensional echocardiography in acute and recovery stages of KD. Data were analyzed with t -test and the linear regression analysis test. Results The serum level of BNP in acute stage was (517.26 + 213.40) ng/mL and was significantly higher than that in recovery stage (91.56 + 47.97) ng/mL, and higher than that in control group (91.56 + 47.97) ng/mL (P < 0.01). The levels of LVEF, LVSF and CI in the acute stage were significantly lower than those in the recoverystage ( P < 0.0%), but there was no significant difference in E/A between acute stage and recovery stage (P > 0.05). The BNP level had negative correlation with the levels of LVEF, LVSF and CI(r = -0.63, -0.52, and - 0.53, respectively, P < 0.05), but had no significant correlation with E/A (r = - 0.18, P > 0.05). Conclusions The serum levels of BNP increase significantly in the KD patients, and have negative correlation with the levels of LVEF, LVSF and CI. The detection of serum levels of BNP has an important significance for diagnosis of KD.

Dopa-responsive dystonia (DRD) is a complex genetic disorder with either autosomal dominant or autosomal recessive inheritance, with autosomal dominant being more frequent. Autosomal dominant DRD is known to be caused by mutations in the GCH1 gene, with incomplete penetrance frequently reported, particularly in males. Here, we report a male patient with DRD caused by exon 1 deletion in the GCH1 gene inherited from the asymptomatic mother. The patient had an atypical presentation, notably with no dystonia, and underwent extensive workup for a myriad of neuromuscular disorders before a low-dose L-dopa trial and confirmatory genetic testing were performed. Our experience with this family highlights an atypical presentation of DRD and prompts us to consider the genetic complexity of DRD.

Objective:To investigate the clinical characteristics of neonatal congenital tongue base cyst.Methods:This retrospective study involved 35 neonates with congenital tongue base cyst diagnosed in the neonatal intensive care unit (NICU) of Xi'an Children's Hospital from June 2013 to December 2019. General information, clinical manifestations, supplementary results, treatment and prognosis of these babies were described.Results:(1) The median age at the onset of the disease was 12.5 (0~28) d and the median age at admission was 15 (0~28) d for these babies. The main clinical manifestations were laryngeal stridor (28/35, 80.0%), inspiratory dyspnea and crying, especially when feeding (26/35, 74.3%) and choking and spitting with feeding (23/35, 65.7%). (2) Among the 35 cases, 15 (42.9%) required emergency endotracheal intubation due to significant dyspnea when were admitted to the NICU and five out of them were considered for having tongue base mass under laryngoscopy, while the other 10 cases underwent bedside electronic laryngoscopy after endotracheal intubation, in which space-occupying lesions were found. Tongue base cyst was considered in seven cases with laryngeal stridor complicated by protracted pneumonia using fiberoptic bronchoscopy. The other 13 cases were examined by electronic laryngoscope and considered as tongue base cyst. Thirty-five cases underwent cervical ultrasound and only five of them were considered as tongue base tumor. Thirty-two cases underwent cervical CT scan and only two of them were normal. Three cases were found to have tongue base cyst by cranial MRI. (3) Thirty-four cases were treated by radiofrequency ablation assisted with self-retaining microlaryngoscope and general anesthesia, while the other one firstly received puncture and drainage under direct laryngoscope due to the difficult intubation because of the huge tongue base cyst and then underwent surgery when stable. Only one case (2.9%) relapsed after surgical treatment during regular follow-up.Conclusions:Neonatal congenital tongue base cyst has an early onset and atypical clinical manifestations. Electronic laryngoscopy/fiberoptic bronchoscopy combined with neck CT or MRI examination should be performed promptly in patients with laryngeal stridor and inspiratory dyspnea to facilitate the accurate diagnosis and timely surgery is required for.