Objective To investigate the effects of permissive hypercapnia (PHC) strategy used in ventilated newborn swine with respiratory failure on cerebral blood flow (CBF) and tissue metabolism. Method Eighteen newborn swine were randomly (random number) divided into 3 groups (n = 6): PHC, normocapnia (NC) and normal control groups. In PHC (PaCO2 50～60 mmHg) and NC (PaCO2 35 ～ 45 mmHg) groups, newborn swine were ventilated for treating respiratory failure induced by meconium aspiration. CBF was measured by using colored microsphere tracking technique. Cerebral oxygen metabolism rate (CMRO2), cerebral glucose metabolism rate (CMRGlu), and cerebral lactate production (CLP) were measured. Results After ventilation for 6 hours and 12hours, CBF in NC group decreased more significantly than those did in control group, and CMRGlu and CLP increased more significantly than those did in control group. In NC group, CMRO2 decreased more prominently than it did in control group 12 hours later. The CBF/CMRGlu and CBF/CLP ratios in NC group were lower than those in control(P＜0.05). There was no significant difference in CBF/CMRO2 ratio between NC and control groups. After ventilation for 6 hours, CBF in PHC group was lower than those in control group. But after ventilation for 12hours, CBF in PHC group increased and there was no significant difference in CBF between PHC group and control group (P＞O.05). There were no significant differences in CMRGlu, CLP and CMRO2 between PHC group and control group. The CBF/CMRGlu and CBF/CLP ratios in PHC group were lower than those in control, but higher then those in NC group (P＜0.05). There was no significant difference in CBF/CMRO2 ratio between PHC and control groups. Conclusions The reduction of cerebral blood flow and the disturbance of CBF autoregulation disturbance occur in ventilated newborn swine with hypoxemia respiratory failure. PHC may attenuate the reduction in CBF and the disturbance of CBF autoregulation.

Thyrocytes expressing MHC class Ⅱ molecules were separated from transgenic mice and were co-cultured with autologous spleen T lymphocytes. T cells did not proliferate and were not activated, but CD4+ T cells were promoted into apoptosis.

Objective To investigate the efficacy of continuous veno-venuous hemodialysis/filtration(CVVHD/F) for the treatment of multiple organ dysfunction syndrome(MODS)caused by severe infection and to explore the mechanism in children.Method Nineteen cases of pediatric septic shock with MODS were treated with CVVHD/F in Children's Hospital Affiliated to Shanghai Jiaotong University from December 2002 to November 2007.The clinical data were studied including mortality rate,serum electrolytes,arterial partial pressure of oxygen (PO2),artery partial pressure of carbon dioxide(PCO2),FiO2/PO2,urine output,blood pressure,doses of vasoactive agents,Cr,BUN,etc.Results Cannulation and CVVHD/F were well performed in a total of 19 cases,with median age 33.4±36.5 months(from 3 months to 8 years) ,with their gender ratio of male(13 cases)to female (6 cases) to be 68.4% and 31.6%.The mean pediatric crifcal illness score(PCIS) was 69.1±10.4 and Median Pediatric Risk of Mortality score(PRMS Ⅲ)12.66±7.85,respectively.The duration of CWHD/F was 92 hours(ranged from 16 hours to480 hours).FiO2/PO2,PCO2,and PO2 were iraproved significantly after 12 to 24 hours CVVHD/F in patients with acute respiratory distress syndrome(ARDS) or lung edema (P<0.05).The concentrations of serum kalium,natrinm and HCO3- level resumed to well-balanced in 24 hours (P<0.05).The serum Cr and BUN were decreased to normal range(P<0.05).The mortality rate was 63.2%.Conclusions CVVHD/F was effective for treatment of septic shock with MODS in pediatric by improving oxygenation,maintaining normal serum electrolytes,conecting metabolic acidosis,increasing the tissue perfusion and eliminating the serum Cr and BUN.

Objective:Explore the relationship among maternal age,risk factors and pregnancy outcomes.Methods:All childbirth women in Zhujiang hospital of Southern medical university from January 1,2015 to October 31,2016 were recruited and divided into 4 groups according to age:543 cases(13.76％) in ≤24 years old,1648 cases in 25-29 years old(41.18％),1208 cases in 30-34 years old(30.61％),547 cases in ≥35 years old (13.86％).Data of 4 groups about pregnancy complications and outcomes were collected.Set group 20-29 years old as the control group(OR =1).Use x 2 test and binary-logistic regression to analyze data.Results:The elder groups had a higher rate in pregnancy complications and abnormal neonatal situation compared to other age groups.The group ≤24 years old and the group in 30-34 years old had a higher risk on preeclampsia and birth defects,respectively.In the group age ＞30 years old,OR ＞ 1 in following items:the histories of abnormal pregnancy,IVF-ET postoperative,pregnancy with uterine fibroid,gestationaldiabetes and scar uterus,and with the increase of age,the OR value increased.In the group age ＞50 years old,OR ＞ 1 in placenta previa,multiple pregnancy and postpartum hemorrhage,macroscopic delivery and low birth weight,premature infants.In the group 30-34 years old,OR ＞ 1 in birth detects.Conclusions:Different specific targeted examinations and health care work should be taken to pregnant women according to the age.Intervention for high risk factors,active treatment related to congenital disorders and prevention of complications are needed to timely choose the best way of delivery,comprehensive security maternal and child health.

Objective:Explore the relationship among maternal age,risk factors and pregnancy outcomes.Methods:All childbirth women in Zhujiang hospital of Southern medical university from January 1,2015 to October 31,2016 were recruited and divided into 4 groups according to age:543 cases(13.76％) in ≤24 years old,1648 cases in 25-29 years old(41.18％),1208 cases in 30-34 years old(30.61％),547 cases in ≥35 years old (13.86％).Data of 4 groups about pregnancy complications and outcomes were collected.Set group 20-29 years old as the control group(OR =1).Use x 2 test and binary-logistic regression to analyze data.Results:The elder groups had a higher rate in pregnancy complications and abnormal neonatal situation compared to other age groups.The group ≤24 years old and the group in 30-34 years old had a higher risk on preeclampsia and birth defects,respectively.In the group age ＞30 years old,OR ＞ 1 in following items:the histories of abnormal pregnancy,IVF-ET postoperative,pregnancy with uterine fibroid,gestationaldiabetes and scar uterus,and with the increase of age,the OR value increased.In the group age ＞50 years old,OR ＞ 1 in placenta previa,multiple pregnancy and postpartum hemorrhage,macroscopic delivery and low birth weight,premature infants.In the group 30-34 years old,OR ＞ 1 in birth detects.Conclusions:Different specific targeted examinations and health care work should be taken to pregnant women according to the age.Intervention for high risk factors,active treatment related to congenital disorders and prevention of complications are needed to timely choose the best way of delivery,comprehensive security maternal and child health.

Data were collected through questionnaire from 505 women enrolled during early pregnancy.Based on soy intake frequency,the subjects were divided into three groups:frequent (three or more times per week),conventional ( more than twice per month but less than three times per week),and occasional ( two or fewer times per month).Serum TSH and FT4 were measured by chemiluminescence immunoassay.The urinary concentrations of two primary isoflavones (daidzein and genistein) and creatinine were further assessed in 95 subjects from the three groups.The percentages of frequent,conventional,and occasional consumers were 18.6％,62.6％,and 18.8％,respectively.No difference was found in age,medical records,family history of thyroid diseases,serum FT4,TSH,and prevalence of thyroid dysfunctions among three groups. Both urinary daidzein and genistein levels were significantly higher in the frequent consumers compared with the other two groups.No correlations were found between urinary isoflavone levels and serum FT4 or TSH.These findings suggest that dietary soy consumption during early pregnancy seems not to be associated with the development of thyroid dysfunction.

Objective To explore whether maternal subclinical hypothyroidism gives rise to poor performance in the offspring and whether this is associated with the expression of several genes that are under the control of thyroid hormones. Methods Sixty female rats were divided into three groups ( each group n = 20): ( 1 )maternal subclinical hypothyroidism ( total thyroidectomy with T4 infusion), (2) maternal hypothyroidism ( total thyroidectomy without T4 infusion), and (3) control (sham operated). All rats were mated 10 days after the start of infusion. The infusion continued until 10 days postpartum. Pups were sacrificed at postnatal day 3, 7, and 21. The hippocampus was collected and tested for brain-derived neurotrophic factor (BDNF) and Rap1 protein expression by Western blotting and for BDNF and neural cell adhesion molecule ( NCAM ) mRNA expression by real-time polymerase chain reaction. On day 41-49, rat pups explored the Morris water maze. Time spent in the quadrant previously containing the plat form was recorded. Results The present study found decreases in BDNF mRNA (on day 3 ) and protein levels (on day 3 and 7 ) in hippocampi of pups from subclinical hypothyroidism dams (P＜0.05). No change was observed in the levels of NCAM mRNA, whereas at day 21, expression of Rap1 protein was higher than that of control offspring. In addition, pups of subclinical hypothyroidism dams showed a trend toward depression in short-term memory (P＞0.05), and long-term memory testing revealed a trend toward subclinical hypothyroidism group pups being less able to remember a fixed platform position than controls, spending less time in the proper quadrant ( P＜0. 05 ). Conclusion The long-term memory deficits of pups born to maternal subclinical hypothyroidism dams are likely related with decrease in BDNF expression as well as increase in Rap1 expression in hippocampi.

Objective To investigate the value of positron emisson tomography-computed tomography ( PET-CT) in monitoring the residual lesions in lipiodol sedimentary region and extrahepatic metastastic lesions of hepatocellular carcinoma ( HCC) with alpha fetoproteins ( AFP) positive after interventional therapy. Methods The data of 20 cases with primary HCC confirmed by histopathology were retrospectively analyzed. Their AFP levels decreased to normal range after interventional treatments, but rose to abnormal high level during following-up. After the abdominal routine imaging examinations, the definite diagnosis of the residual lesions in lipiodol sedimentary region or extrahepatic lesions can't be made confidently. All cases were scanned by PET-CT, and according to their PET-CT results, the further treatments were given and the therapeutic results were monitored with radiology and AFP tests. Results In all 20 cases, 10 of them were detected to have the extrahepatic metastastic lesions by PET-CT, including 4 with abdominal wall metastasis upon the liver, 3 with solitary pulmonary metastasis with diameter less than 1 cm, 2 with mesenteric mestastasis, 1 with mestastasis of operative incisions, but these lesions were neglected by abdominal routine imaging examinations. Eight cases showed the uneven lipiodol sedimentary region in the primary lesion by CT or MRI examination, but can't be diagnosed whether it was residual lesion with other examinations including DSA. A definite diagnosis was obtained by PET-CT. In 2 cases, lymph nodes less than 1. 5 cm were found in the hepatic portal area(PHA) and retroperitoneum on CT images,which was determined to be metastatic by PET-CT. All the detected lesions were given further treatments of surgery or interventional therapy. Most patients showed decreased AFP levels except the 2 patients with lymph node metastasis. The imaging examinations also indicated that the treatments had a good effect on lesions. Conclusion In the patients with HCC and abnormal high levels of AFP, in addition to abdominal routine imaging examinations, PET-CT is beneficial for those who is suspected of residual lesions in lipiodol sedimentary region or extrahepatic metastasis.

objective To evaluate the distribution and significance of IgG subclasses of antithyroglobulin antibody in sera from patients with Hashimoto thyroiditis.Methods Sera from 112 patients with Hashimoto thyroiditis were collected and patients were divided into 3 groups,i.e.hypothyroidism,subclinical hypothyroidism and euthyroidism.Antigen specific ELISA was used to detect the distribution of IgG subclasses of antithyroglobulin antibody.Results The positive rates of IgG subclasses of TgAb were IgG1 90.2%,IgG2 58.0%,IgG3 19.6%and IgG4 87.5%respectively.The mean geometric titers of IgG1 in sera from patients with hypothyroidism and subclinical hypothyroidism were 1:450.8 and 1:245.5 respectively,both being significantly higher than that with euthyroidism(1:8.7,P＜0.01).The mean geometric titers of IgG2 in sera from patients with hypothyroidism and subclinical hypothyroidism were 1:37.3 and 1:3.2 respectively,both being also significantly higher than that with euthyroidism(1:0.2,P＜0.01 and P＜0.05 respectively)and that with hypothyroidism was significantly higher than that with subclinical hypothyroidism(P＜0.05).Conclusion The distribution of IgG subclasses of antithyroglobulin antibody in sera from patients with Hashimoto thyroiditis was predominantly IgG1,IgG2 and IgG4.High titers of IgG1 and IgG2 implicated the possibility of development from subclinical hypothyroidism to overt hypothyroidism.

Objective To determine the factors that influence the development of abnormal thyrotropin (TSH) level in an euthyroid population.Methods We conducted a follow-up study in 3 communities with different iodine status.Of the 3403 euthyroid subjects at baseline screened in 1999,80.1% ( n = 2727 ) was visited and sampled in 2004 for measuring TSH,thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb).Results Iodine status in the 3 communities were stable.Decreased TSH level( <0.3 mU/L) developed in 2.5% (n =68) of sampled subjects,while raised TSH level( > 4.8 mU/L) in 2.4% (n = 64).A logistic analysis showed that risk factors for developing decreased TSH level included positive conversion of TPOAb (OR = 5.5 ),positive TPOAb both in 1999 and in 2004 ( OR = 4.0),positive TgAb in 2004 ( OR = 3.7) and TSH < 1.0 mU/L in 1999 ( OR = 2.6).Risk factors involved in developing raised TSH level included iodine status of Zhangwu community ( OR = 4.1 ),iodine status of Huanghua community ( OR = 3.9),positive TgAb in 2004 ( OR = 3.7 ),positive TPOAb both in 1999 and 2004 (OR =3.6),positive conversion of TPOAb (OR =2.7) and TSH > 1.9 mU/L in 1999 (OR = 2.6 ).Conclusions Exposure to long-term iodine excess imposes danger of developing hypothyroidism.The risk will be even higher when exposing to iodine adequacy after correction of iodine deficiency.An interval between 1.0 and 1.9 mU/L of TSH level was optimul with the least probability of developing abnormal TSH level.