Objective To explore the related risk factors of severe mycoplasma pneumonia in children.Methods 86 children with mycoplasma pneumonia were selected as the observation group.At the same time,30 normal children were selected as the control group.The observation group included 33 cases of mild mycoplasma pneumo nia(A group) and 53 cases of severe mycoplasma pneumonia(B group).The clinical data of the three groups were ret rospectively analyzed,and the related risk factors of severe mycoplasma pneumonia in children were analyzed.Results The risk factors of severe mycoplasma pneumonia in children were age ＞ 5 years (x2 =28.776,P ＜ 0.05),immunoglobulin IgG(x2 =3.004,P ＜ 0.05),immunoglobulin IgM (x2 =2.147,P ＜ 0.05),immunoglobulin IgA (x2 =2.036,P ＜ 0.05),WBC (x2 =6.119,P ＜ 0.05),neutrophil percentage (x2 =8.374,P ＜ 0.05),the positive rate of CD8(x2 =11.665,P＜0.05),the positive rate of CD4(x2 =12.901,P＜0.05).Conclusion For children with risk factors of severe mycoplasma pneumonia should be early diagnosed,prevented and treated,thereby reducing the burden on patients.

BACKGROUND: How dose sodium nitroprusside, as a vasodilatator, affect the potential of bone marrow-derived mesenchymal stem cells (MSCs) in hematopoietic differentiation?OBJECTIVE: To observe the changes during the differentiation of MSCs into hematopoietic cells after adding sodium nitroprusside, and compare the results with those of simple MSCs transplantation.DESIGN: A randomized grouping, controlled observation.SETTINGS: Department of Microbiology and Immunology; Department of Pathophysiology, Guangdong Medical College.MATERIALS: The experiments were carried out in Guangzhou Medical College in August 2006. Twenty-seven clean-degree balb/c mice of 7-8 weeks, were used as recipients, and were randomly divided into MSCs transplantation group (n =9), sodium nitroprusside+MSCs transplantation group (n =9) and blank control group (n =9). Another 4-week-old SD rat was selected as the MSCs donor. Sodium nitroprusside for injection (50 mg/piece) was provided by Beijing Double-Crane Modern Pharmaceutical Technology Co., Ltd (National drug approval: No. H11020907).METHODS: ① Under aseptic condition, the femur of SD rat was collected. MSCs in it were isolated for culture and amplifying in vitro. MSCs of passages 6-7 were digested and centrifugated, and the density was adjusted to 1×109 L-1.Monoclonal antibody with fluorescence labeled was added into cell suspension, and the phenotype was detected with flow cytometry. ② Sodium nitroprusside (50 mg/piece) was adjusted to the terminal concentration of 200 mg/L by adding with saline. It should be used within 4 hours. ③ Before transplantation, all the mice were exposed to 5.0 Gy. X-ray for 4 hours, and the absorbed dose was 1.45 Gy per minute. After irradiation, mice in the MSCs transplantation group were directly infused via caudal vein with 0.3 mL MSCs suspension (containing 1.5×106 cells); The mice in the sodium nitroprusside+MSCstransplantation group were firstly injected with the dispensed 200 mg/L sodium nitroprusside (0.15 mL), and immediately infused with 0.3 mL MSCs suspension (containing 1.5×106 cells) after 1 minute; The mice in the blank control group were infused with isovolume serum-free culture medium. ④ At 60 days after transplantation,peripheral blood was drawn from orbits of the survived mice in each group, single cell suspensions of bone marrow and spleen were prepared after the mice were killed, the levels of rat-derived hematopoietic cells CD11a and CD45 were detected with flow cytometry.MAIN OUTCOME MEASURES: ① MSCs culture and amplification; ② Levels of rat-derived hematopoietic cells in different tissues.RESULTS: All the 27 balb/c mice as recipients survived to the end of the experiment. ① MSCs isolation and amplification: The MSCs attached with uniform shapes of spindle and proliferated rapidly after culture for 3 days, and 90% of the cells were fused without overlapping at 6 days. The cells attached completely within 24 hours after passage,extended and became spindle again, rapidly proliferated and grew, and became fused completely at 3 days. ② Levels of rat-derived hematopoietic cells in different tissues: In the MSCs transplantation group and sodium nitroprusside+MSCs transplantation group, Iow expressions of rat-derived CD11a and CD45 hematopoietic cells could be detected in peripheral blood, bone marrow and spleen, and they were obviously higher in the sodium nitroprusside+MSCs transplantation group than in the MSCs transplantation group (t=2.619, P ＜ 0.05), while negative ones in the blank control group.CONCLUSION: MSCs have the ability to differentiate into hematopoietic stem cells, which can be promoted by sodium nitroprusside.

BACKGROUND: Logistic analysis of multi-ordered response-variable is used to probe into from another view the interrelationship between lead content in fetus faeces and neurobehavioral development under exposure to low-level lead in uterus.OBJECTIVE: To probe into multi-factors of neurobehavioral development in neonates and the sensibility.DESIGN: The total score of neurobehavior in neonates was taken as dependent variable and 24 indexes were as independent variables, such as induced factors, lead in umbilicus blood and lead in fetus faeces in questionnaire. Logistic progressive regression of multi-ordered response-variables was used in analysis and corresponding factors were screened at level of P=0.10.SETTING: Wuhan University of Science and Technology, Laboratory Room of Occupation Disease and Epidemic disease in Tongji Medical College of Huazhong University of Science and Technology and Occupation Hospital of China First Metallurgical Construction General Company.PARTICIPANTS: Totally 103 full-month borne and healthy neonates were randomized in Department of Gynecology of one occupation hospital in Qingshan District of New-type Industry Area of Huanhan City from January to October 1999 as the objects. The relatives agreed with topic research and questionnaire investigation and they provided neonatal faeces and received neonatal tests on time.off the umbilicus and preserved in freezing in refrigerator at -4 ℃. The faeces in 24 hours after birth was collected and the lead contents of umbilicus blood and faeces were assayed with graphite furnace atomic absorpBehavioral Neurological Assessment (NBNA) was used in examination on the 3rd day after delivery. Simultaneously, the self-designed questionnaire was adopted in the investigation for parturients. The questionnaire involved other possible factors of neonatal neurobehavioral development, including dependent variables, concerning to states of family, society, environment and health that affected neurological development in neonates and lead contents in umbilicus blood and faeces. Scores of neonatal neurobehavior were taken as response variables. Finally, the corresponding factors were screened.MAIN OUTCOME MEASURES: To screen the factors of neurobehavioral development of neonates.RESULTS: Totally 103 cases entered result analysis. Six factors were selected in the model, named pregnant weeks, the month of drug administration in pregnancy, hemoglobin, emotions in pregnancy, lead level in fetus faeces and drug administration.CONCLUSION: Neonatal neurobehavioral development was related to multiple factors. Good nutrient in pregnancy, long pregnant weeks and good emotions in pregnancy benefit neurobehavioral development of neonates. Drug administration during pregnancy is disadvantageous in neonatal neurobehavioral development, especially the medication at the early phase of pregnancy. The increased lead content in neonatal faeces does not benefit neonatal neurobehavioral development.

BACKGROUND: In the past, a lot of researches used one-time lead level in umbilical cord blood at birth for investigations,however, one-time lead level in umbilical cord blood at birth can not represent lead caused cumu lative injury to neonatal nervous system during the whole period of preg nancy. Lead in meconium is mainly from digestive juice secreted by fetal alimentary tract, exfoliative epithelia from neonatal intestinal tract and am niotic fluid and sebum cutaneum swallowed by fetus, which is excreted from the very start of pregnancy to 24 hours after birth of neonates and re flects the lead deposit in neonatal intestinal tract during the whole period of pregnancy. OBJECTIVE: To explore the relationship between neurobehavioral devel opment in neonates with intrauterine exposure to lead at low level and the lead level in umbilical cord blood (CBPb) and meconium (MPb). DESIGN: Take lead levels in umbilical cord blood and meconium as neonatal intrauterine exposure indicators and scores of neonatal neurobe havioral development as effect indicators, and descriptive analysis is used to evaluate the correlativity. SETTING: Wuhan University of Science and Technology; Laboratory of Occupation Disease and Epidemiology, Tongji Medical College, Huazhong University of Science and Technology; Wuhan First Metallurgical Con struction Company Hospital for Workers and Staff. PARTICIPANTS: A total of 103 cases of full-term and healthy neonates were selected as objects of observation. The neonates were born in Depart ment of Gynecology and Obstetrics, Wuhan First Metallurgical Constrction Company Hospital, Qingshan District of New Industrial District of Wuhan from January to October 1999. Their parents were agreed to participate in the study and filled in the questionnaire, and provided neonatal meconium and performed neonatal tests on schedule. METHODS: ① Collection and assay of sample: 5 mL umbilical cord blood were collected and reserved in refrigerator at -4 ℃. Meconium with in 24 hours after birth, with dry weight between 5 to 10 g was collected, the lead levels in umbilical cord blood and meconium were assayed with the method of graphite furnace atomic absorption spectroscopy. ② Group ing: The neonates were divided into two groups with high and low-exposure to lead based on the cutoff value of CBPb of 0.483 μmol/L and MPb of 127.78 mg/kg. ③ Neonatal neurobehavioral development examination: Neonatal neurobehavioral development examination method was used for examination 3 days before delivery. Meanwhile, self-designed questionnaire was used to conduct a survey in puerperas. MAIN OUTCOME MEASURES: ① Lead levels in neonatal umbilical cord blood and meconium. ② Scores of neurobehavioral development of neonates with different lead levels of umbilical cord blood and meconium. RESULTS: All the 103 cases of neonates entered results analysis. ①There was significant difference only in scores of neonatal behavioral neurological assessment (NBNA) and biological visual and auditory orientation reaction (BVAOR)between groups with high and low-exposure to lead in umbilical cord blood (P ＜ 0.05). However, there was no rank correlativity between lead level in umbilical cord blood and scores of NBNA,non-biological auditory orientation reaction (NBAOR), non-biological visual orientation reaction (NBVOR) and biological visual and auditory orientation reaction (NBVOR). ②here was significant difference in scores of NBNA,NBAOR, NBVOR and BVAOR between groups with high and low-exposure to lead in meconium (P ＜ 0.05-0.01). The lead level in meconium clearly correlated reversely with scores of NBNA, NBVOR and BVAOR.CONCLUSION: Lead level in meconium is more sensitively related to the scores of neonatal neurobehavioral development, which could be used as indicator for lead deposit in the fetal body during the period of pregnancy.

Objective To investigate probable effect of metformin on anxiety and autophagy pathway in rats with focal cerebral ischemia . Methods The rats were divided into seven groups:shame group, ischemia group, metformin group, compound C group, compound C +ischemia group, metformin+ischemia group, and metformin+compound C+ischemia group.The rats were administered with metformin 14 days and compound C 30 min pretreatment.The blood glucose level, body mass, neurological score and indicators of elevate plus maze test were recorded of two groups after 72h ischemia-perfusion.The autophagy-related protein of Atg-7, Atg-5, beclin-1 were analysed by Western blot.ResuIts Metformin had no significant effect of body mass and blood glucose level.The prior administration of metformin significantly elevated neurological score in ischemia group (P<0.01).The elevate plus maze test results showed that prior administration of metformin significantly elevated percentage of open-arms detention time in ischemia group (P<0.01), but there was no significant difference in open-arms times.Western blot result showed that prior administration of metformin significantly elevated Atg-7, Atg-5, beclin-1 protein expression in ischemia group (P<0.001).Compound C resist the above effects of metformin (P<0.01).ConcIusion The metformin improves psychological disorders and movement disability through regulation of autophagy following focal cerebral ischemia in rats.

The determination of plasma factor Ⅷ related antigen (ⅧR:Ag) is a new method to estimate the function of blood coagulation introduced only recently. The concentration of this substance of 50 patients ill with chronic renal failure, neoplastic diseases, diabetes mellitus, (all these diseases were complicated with vascular changes) and 60 normal persons were determined.The data obtained showed that the concentration of plasma factor Ⅷ related antigen was significantly increased in all the 50 patients in comparing with the normal, and the increase was most marked in those patients with malignant diseases. The clinical significance of this phenomenon was discussed and it was suggested that the increase of this plasma factor Ⅷ related antigen might reflect the severity of the damage of the vascular endothelial cells in these patients.

Objective To study the difference between intensity-modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) for pelvic radiation of post-operative treatment with gynecologic malignant tumor. Methods A prospective investigation study was conducted on 183 patients of post-operative patients with whole pelvic radiation therapy of cervical cancer or endometrial cancer in Zhejiang Cancer Hospital [IMRT group (n=85) and 3D-CRT group (n=98)] from Oct. 2015 to Oct. 2016. The two groups received same dose (45 Gy in 25 fractions). Comparison of two groups with radiation dosimetry:the score according to the Radiation Therapy Oncology Group (RTOG) acute radiation injury grading standards before and after radiotherapy reaction, the score from functional assessment of cancer therapy scale-cervix (FACT-Cx) scale and expanded prostate cancer index composite for clinical practice (EPIC-CP) scale were also analyzed. Results (1) There were no significant effect with age, culture level, family economic condition and ratio of radiochemotherapy between two groups (all P>0.05). (2) Dosimetric comparison for IMRT vs 3D-CRT:the average dose of planning target volume (PTV) decreased(46.1 ± 0.4) vs(46.4 ± 0.5)Gy, V45 dose percentage increased(95.2 ± 1.0)%vs (93.3 ± 2.0)%, intestinal bag dose of V40 decreased(24.4 ± 6.8)%vs (36.5 ± 15.9)%, rectal V40 dose percentage decreased(73.9 ± 12.3)%vs (85.4 ± 8.4)%, and lower rectal V45 dose percentage(32.8 ± 13.4)%vs (71.5 ± 13.7)%, bladder V40 dose percentage decreased(55.5 ± 13.0)% vs (84.4 ± 13.0)%. Bone marrow V20 lower:(67.9 ± 5.4)% vs (79.5 ± 6.6)%, V10 lower:(82.1 ± 6.0)% vs (86.3 ± 6.6)%; there were significant differences (all P<0.05). There was no significant difference between the dose of V45 in the intestinal pouch and bladder (P>0.05). (3) Acute radiation injury classification for IMRT vs 3D-CRT:big or small intestine:Ⅱ-Ⅲreaction [13%(11/85) vs 24% (24/98); χ2=3.925, P=0.048], there was significant difference. Bladder: Ⅲ reaction [19% (16/85) vs 26% (25/98); χ2=1.171, P=0.279], there was no significant difference. Radiochemotherapy of bone marrow suppression:Ⅲ-Ⅳreaction (14/20), the incidence rate [26%(14/54) vs 31%(20/65);χ2=0.339, P=0.562], the difference was not statistically significant. (4) Quality of life scale by FACT-Cx scale in IMRT vs 3D-CRT:there were no significant difference before radiotherapy (82 ± 16 vs 85 ± 16;t=1.279, P=0.203), while there was significant difference after radiotherapy (76 ± 14 vs 71 ± 18;t=-2.160, P=0.032). EPIC-CP scale score:before radiotherapy they were (16±7 vs 15±6;t=-0.174, P=0.862) ,but after radiotherapy (18±7 vs 22± 7; t=3.158, P=0.002), there was significant difference between them. Before and after radiotherapy, the increased EPIC-CP scale of the IMRT group vs 3D-CRT group were 3 ± 4 and 6 ± 4, the 3D-CRT group was significantly higher, the difference was statistically significant (t=5.500, P=0.000). Conclusion IMRT has shown that there are a significant benefit for the post-operative patients with cervical cancer and endometrial cancer compared to 3D-CRT.

Objective To construct Z-score models for normal fetal heart size measurements derived from fetal echocardiography.Methods Fetal echocardiography were performed in 910 normal singleton fetuses from 14th to 40th gestational weeks.Fetal transverse heart diameter (HD),heart length (HL),heart circumference (HC) and heart area (HA) were derived from a standard four-chamber view during end diastole.Using fetal somatic sizes as independent variables and heart sizes as dependent variables,the regression analyses of the mean (M) and the standard deviation (SD) for each parameter were calculated separately.A group of fetal heart diseases were assessed using these models.Results Strong correlations were found between fetal heart sizes and somatic sizes.Linear-cubic regression equations were each fitted to the models of the means of the heart sizes,whereas linear-quadratic equations were fitted to the models of the SDs.HD (r =0.984-0.986) was a dependent variable that provided the highest correlation coefficient with all of the fetal sizes,followed by HL (r =0.981-0.984),HC (r =0.981-0.982) and HA (r =0.978-0.979).All fetuses with Ebstein' s anomaly and most with homozygous α thalassemia-1 demonstrated Z scores reflective of increased heart sizes.Conclusions The fetal heart sizes Z-scores models had been constructed.The calculation of Z-scores for heart sizes as a function of fetal somatic size is feasible and simple.They might be useful for quantitative assessment of some cardiac diseases and used as new predictive indicators for homozygous α-thalassemia-1 particularly.

Objective To explore airway remodeling and air trapping in asthmatic patients with low dose CT scanning and quantitative analysis. Methods 52 stable asthmatic patients in which 29 were severe and 23 were slight,and 20 healthy control cases were underwent low dose dual phase CT scanning. The LA/BSA, WA/BSA, TA/BSA, WA%and Pi10WA were analyzed as airway remolding indexes. The MLD of expiratory, VI-850 (%) of expiratory, MLD E/I, VI-850E-I (%) and VI-850/-950E-I (%) were analyzed as air-trapping indexes. One-Way ANOVA or H Kruskal-Wallis was used to analyze the above indicators. Results Airway remodeling indexes and LA/BSA were (9.6 ± 2.6), (11.0 ± 3.4) and (12.6 ± 3.0)mm2/m2 in severe asthmatics group, non-severe asthmatics group and healthy control group respectively, and there was significant difference between the three groups (F=5.60, P=0.006). WA%of each group was (65.1 ± 2.5)%, (63.3 ± 4.4)%and (62.0 ± 3.0)%, and there was significant difference between the three groups (F=5.53,P=0.006). The Pi10WA was (18.4±2.6), (17.7±3.1) and (16.4±1.4) mm2 respectively with significant difference between the three groups (F=3.59 ,P=0.033). Air-trapping indexes, MLD of expiratory of each group was-(771 ± 59),-(724 ± 43) and-(676 ± 60) HU respectively with significant difference (F=5.60, P=0.006). VI-850(%) of expiratory of each group was 30.79(30.45)%, 13.53(12.09)%and 2.85(6.87)%respectively with significant difference (H=17.20,P<0.001). Conclusions Low dose of CT scan and quantitative analysis can provide an objective and quantitative information for patients with airway disease of asthma, and both WA% and Pi10WA were objective indexes. The severe asthmatic patients were associated with obvious airway remodeling and air trapping compared with non-severe asthmatic patients.

Objective To explore the correlation between CT characters and epidermal growth factor receptor (EGFR) gene mutations in lung adenocarcinoma. Methods Two hundred and three lung adenocarcinoma patients (from September,2014 to March,2015) confirmed by pathology were divided into effective mutation group (97 cases) and non?effective mutation group (106 cases) on the basis of the site and the response to tyrosine kinase inhibitors. Among all the CT characters, rank?sum test was adopted to analyze the difference of diameter between the two groups; Fisher's exact test was applied to explain the difference of density type and Chi?square test was applied to analyze the difference of lobulation, spiculation, necrosis, pleural indentation, cavitation and air?brochogram signs. Logistic regression was used to analyze the significant signs and evaluate the odds ratio (OR). Results There were 65, 67, 45, 74 cases of lobulation, spiculation, necrosis, pleural indentation in the EGFR gene effective mutation group and 56, 51, 26, 61 cases in non?effective mutation group with statistically significant difference between the two groups (χ2=4.230, 9.141, 10.646, 7.986, P<0.05). However, there were no significant difference between the two groups in the diameter, density, cavitation and air?brochogram (P>0.05). Logistics regression analysis showed that, spiculation (OR=2.120), necrosis (OR=2.853) and pleural indentation (OR=2.094) were in correlation with EGFR effective mutations, and lobulation was not in correlation with EGFR effective mutations. Conclusions Among all the CT sings, spiculation, necrosis and pleural indentation were in correlation with EGFR gene effective mutation, they were more likely to appear in lung adenocarcinoma patients with EGFR gene effective mutation.