Objective To evaluate the effect of N- acetylcysteine(NAC) on lipopolysaccharide (LPS) - sensitized neonatal rats with hypoxic- ischemic brain damage(HIBD) and possible mechanism except the antioxidant. Methods With the total number of 98 Wistar pups at postnatal day 8 of either sex was used in this study. There were 86 pups which were divided into three groups to evaluate the brain injury:vehicle group ( n = 29) ,low dose (25 mg/kg) ( n = 31 ) and high dose NAC (200 mg/kg) ( n - 26) treatment group. The pups were injected with LPS(0.1 mg/kg)intraperitoneally 3 days before hypoxic- ischemic(HI) insult. Multiple dose of NAC (25 mg/kg or 200 mg/kg) or vehicle was injected intraperitoneally before and after HI. Brain injury was evaluated 7 days after HI. For the Caspase - 3 activity and immunoblotting analysis, the samples were collected at 24 h after HI treated either with vehicle or high dose NAC ( n = 6 per group). Results The brain injury volume was significantly reduced by high dose NAC (200 mg/kg) treatment compared with that of vehicle (77% reduction, P ＜ 0.001 ). The tissue loss was reduced 67 % ( P ＜ 0.001 ) in high dose NAC treated group compared with that of vehicle. However,there was no significant reduction of brain injury in the low dose NAC treatment group compared with vehicle group. Caspase - 3 like activity measurement showed that the activity decreased 53 % after high dose NAC treatment ( P ＜ 0. 001 ) compared with that of vehicle treatment. The immunoblots showed that the active form of Caspase - 3, 17 kDa band, was abolished by the high dose NAC treatment. Conclusions NAC treatment attenuate LPS - sensitized neonatal HI brain injury is dose dependent. The neuroprotective effect involves Caspase - 3 inhibition.

ObjectiveTo evaluate the neuroprotective effect and possible mechanisms of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) in neonatal Harlequin (Hq) mutant mice brain after hypoxia-ischemia brain injury(HIBD) insult.MethodsThe nine-day-old male Hq mutant mouse pups were assigned randomly either edaravone (n=16) and vehicle (n=17) treatment group. The Hq mice were subjected to left common carotid artery occlusion combined with inhalation 100 mL/L oxygen for 45 minutes. The mice were injected intraperitoneally either with edaravone (10 mg/kg) or equivalent volume of saline immediately after artery occlusion and after hypoxia. Nitrotyrosine and lipid peroxidation formation were evaluated at 3 h and 24 h after hypoxia-ischemia(HI) by using immunohistochemistry staining. Nitrotyrosine formation and caspases activation were evaluated either by immunoblotting or fluorogenic activity measurement at 24 h after HI. Brain injury was evaluated at 72 h by neuropathological score and calculating the infarct volume.ResultsBrain injury encompassed cortex, hippocampus, striatum and thalamus. Edaravone treatment reduced brain injury significantly in all the brain regions. The total infarct volume was reduced 52.8% in edaravone treatment group compared with vehicle group (P<0.001). The edaravone treatment reduced nitrotyrosine formation as well as lipid peroxidation formation significantly, but without obviously effect on caspases activation.ConclusionEdaravone affords neuroprotection after neonatal HI insult, which correlated with the reduction of free radical formation.

ObjectiveTo determine optimal positive end expiratory pressure (PEEP) in mechanical ventilation in children with severe asthmatoid disease based on the quasistatic pressure-volume (P-V) curve.MethodsA serf-control study was done on 23 children with severe asthmatoid disease in the pediatric intensive care unit( PICU ).Quasistatic lung P-V curve of these patients was analyzed and the lower inflection point (LIP) from P-V curve was determined.Three different PEEP (0 cm H2O,LIP,LIP+2 cm H2O,1 mm H2O =0.098 kPa) were given to the patients.The effects of PEEP at different levels on gas exchange,hemodynamic and airway pressure were observed.ResultsThe quasistatic LIP were (2.70 ±2.00)cm H2O.When PEEP was increased to the level of LIP + 2 cm H2O,PaO2 / FiO2 and lung compliance improved significantly (P ＜ 0.01 ) and dynamic lung compliance was the highest,peak inspiratory pressure was (22.30 ± 3.00) cm H2O and mean airway pressure was( 14.11 ± 1.01 ) cm H2O,without obvious adverse effects on mean arterial blood pressure and heart rate.There was no difference in PaCO2,when compared PEEP =0 cmH2O to PEEP =LIP + 2 cmH2O.ConclusionThe application of PEEP is safe.LIP + 2 cm H2O from quasistatic P-V curve could be set as the optimal PEEP under which mechanical ventilation has the best efficacy and do not aggravate CO2 retention and abnormality of hemodynamics in children with severe asthmatoid disease.

Objective To analyze the incidence rate and mortality of perinatal asphyxia and effects of new resuscitation technique on asphyxia as well as the risk factors of asphyxia in latest 10 years.Methods A retrospective evaluation was done for all the newborns who were born in the provincial women and children′s health care hospital from 1995 to 2004.The morbidity,mortality and fatality rate were calculated for each observed year and different seasons.The influence of gender,body weight,gestational age as well as polyembryony and mode of delivery on the asphyxia was analyzed.Results The morbidity of mild birth asphyxia was decreased dramatically and maintained at about 1.5% after using new resuscitation technique,however,there were no obvious effects on the sever asphyxia.In the same time,no big influence on fatality rate of birth asphyxia was observed.The incidence rate was highest in April,but the mortality and fatality of asphyxia was highest in July.The incidence of asphyxia was also related with gender,polyembryony,birth weight,prematurity babies and aids to delivery from voginal.Conclusions The incidence of perinatal asphyxia is related with the gender,polyembryony,birth weight and gestation age as well as seasons.New resuscitation technique can reduce the morbidity of mild birth asphyxia,and no effect on the severe asphyxia as well as fatality rate.

Objective To evaluate the neuroprotective effect and possible mechanisms of edaravone(3-methyl-1-phenyl-2-pyrazolin-5-one) in neonatal Harlequin(Hq) mutant mice brain after hypoxia-ischemia brain injury(HIBD) insult.Methods The nine-day-old male Hq mutant mouse pups were assigned randomly either edaravone(n=16) and vehicle(n=17) treatment group.The Hq mice were subjected to left common carotid artery occlusion combined with inhalation 100 mL/L oxygen for 45 minutes.The mice were injected intraperitoneally either with edaravone(10 mg/kg) or equivalent volume of saline immediately after artery occlusion and after hypoxia.Nitrotyrosine and lipid peroxidation formation were evaluated at 3 h and 24 h after hypoxia-ischemia(HI) by using immunohistochemistry staining.Nitrotyrosine formation and caspases activation were evaluated either by immunoblotting or fluorogenic activity measurement at 24 h after HI.Brain injury was evaluated at 72 h by neuropathological score and calculating the infarct volume.Results Brain injury encompassed cortex,hippocampus,striatum and thalamus.Edaravone treatment reduced brain injury significantly in all the brain regions.The total infarct volume was reduced 52.8% in edaravone treatment group compared with vehicle group(P

Child ; Humans ; Multiple Organ Failure

Objective To discuss the methods of selecting different shapes occluder and to evaluate the feasibility,safety and efficacy of them in transcatheter closures of congenital ventricular septal defect (VSD) in children.Methods Transcatheter closures were performed in 226 children with congenital VSD,age ranging from 2 to 14 years(mean 5.62 years) under the guidance of transthoracic echocardiography(TTE) and fluoroscopy.There were 14 patients with intracristal VSD,209 patients with perimembranous VSD and 3 patients with muscular VSD.Left ventriculography and transthoracic echocardiography were performed repeatedly after the procedure to assess the effect of occlusion.The echocardiography and electrocardiography were scheduled before discharge,1,6 and 12 months for the follow-up.Results The occluders were deployed successfully in 211 patients.The successful rate was 93.4%.Thin waist shape occluders,were deployed in 7 patients;equal side shape occluders,were deployed in 191 patients;eccentric shape occluders were deployed in 12 patients,and muscular defect occluders were deployed in 1 patient.There were no complications encountered during or after closure.Conclusions It is very important in transcatheter closure of congenital in children to select different shape occluder according to pathologic characteristics.In general,equal side shape occluder is suita-ble for a large number of defect and it is easy for deployment.In some conditions,the other shape occluder may be necessary.

Animals ; Animals, Newborn ; Brain ; blood supply ; drug effects ; metabolism ; Female ; Hypoxia-Ischemia, Brain ; physiopathology ; Immunohistochemistry ; Lipopolysaccharides ; toxicity ; Male ; Models, Animal ; Random Allocation ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; analysis

Objective To summarize the clinical characters, diagnostic and therapeutic strategy of the cured patient with human H5N1 avian influenza pneumonia in mainland of China,and to provide effective experiences for the physicians to diagnose human avian influenza infection.Methods The clinical data of the cured patient with H5N1 avian influenza infection in China was analyzed.Results The patient was treated with short-term symmetrel and ribavirin for antiviral therapy companied with the lowdosage and long-term(4 weeks) glucocorticoid therapy.The CPAP assistant ventilation was used and the airway was kept unobstructed.The antibiotic was used to prevent and control the followed infection.The supportive treatment was applied to protect the organ′s function of the patient.The pathogenetic condition of the patient became better with the hemogram risen and the lungs pathological changes absorbed gradually.The chest CT reexamined at the 7th day of the hospitalized-term suggested that the left lung fibrosis started to be absorbed and it was obviously absorbed at the 16th day.The breath function and all the internal organs functions became better.The patient convalesced and left hospital at the 46th day.Conclusion In the human avian influenza infection,the pathogenetic condition may progress quickly after the pneumonia appears.The lung injury and lung fibrosis as well as the multi-organs dysfunction were emerged in the patient rapidly.The progression of disease can be controlled and the prognosis can be improved by the prompt and correct treatment.

0. 05). Conclusion On the CTA exams with 64-slice spiral CT, good CTA image quality can be acquired with reduced contrast dose and saline flush, thereby we can afford reliable diagnostic information for the clinicians.