BACKGROUND:Treatment and rehabilitation of spinal cord injury is a complicated problem,andthe reconstruction and remyelination of neural reflex pathwaysare the essentialprocess, during which oligodendrocytes play an important role in spinal cord injury repair.
OBJECTIVE:To observe theeffect ofoligodendrocyte transplantation for acute spinal cord injury in rats.
METHODS:Insulin-like growthfactor 1 induced bone marrow mesenchymal stem cels differentiating into oligodendrocytes, and those oligodendrocytes were transplanted into rats with acute spinal cord injury as induced cel transplantation group. Simple normal salineandnatural oligodendrocytes were transplanted into the rat injured spinal cord as control group and oligodendrocyte group, respectively. Rat behavioral changes were observed by inclined planetest and Basso-Beattie-Bresnahan (BBB) scores. Neurological recovery and survivalof the transplanted cels was detected and observed using spinal evoked potential and immunohistochemical staining, respectively.
RESULTS AND CONCLUSION:Compared with the control group, BBB scores and the criticalelevation angle oftheincline planetestsignificantly increased, latencies of spinal motor and sensory evoked potential were on the decline (P< 0.05), and there were no significant differencesin above indicators between the two groups at 4 and 8 weeks after transplantation. Moreover, survivedoligodendrocytes after transplantation could be found in the lesions of spinal cord in both two groups. In conclusion, insulin-like growth factor 1-induced bone marrow mesenchymal stem cels can differentiate into oligodendrocytesthat exact an excelentrole in acute spinal cord injury repair after transplantation, which achieve the equal clinical efficacy tothenatural oligodendrocytes.

Hoechst 33342 is a kind of fluorescent dye used for evaluating the cell cycle and apoptosis in a variety of benign and malignant cell lines,such as BC3H-1 monocytes,HI-60 cells,HT-144 melanoma cells and hepatoma cells.The inhibitor of topoisomerase I,the alternation of TATA box binding protein.the intraeellular accumulation of E2F-l protein and the mitochondrial dysfunction may play an important roles in the apoptosis pathway indueed bv Hoechst 33342.

Objective To analyze the clinical features of the hyperamylasemia in critically ill children and investigate the related risk factors in order to provide the basis for prevention and treatment. Methods A total of 1036 critically ill children admitted in pediatric intensive care unit (PICU)from April,2011 to Oct,2012 were studied.They were divided into the high amylase group (n=82)and the normal group (n=954).According to the outcomes,the high amylase group was divided into survival group (n=61 ) and death group (n =21 ).The related risk factors of the occurrence and outcome of hyperamylasemia were analyzed by univariate and multivariate Logistic regression.Results There were statistically significant differences in rates of coagulation disorders, convulsions, disturbance of consciousness,pediatric critical illness score (PCIS)≤80,multiple organ dysfunction (MODS)≥3, sepsis,shock,and lactic acid (LA),procalcitonin (PCT),blood glucose (BG)between the high amylase group and the normal group (P<0.05 ).The differences in the rates of coagulation disorders,convulsions, mechanical ventilation,PCIS≤80,MODS≥3,and LA,PCT,oxygenation index,albumin,C-peptide,BG were statistically significant between the survival group and the death group (P <0.05 ).Multivariate Logistic regression analysis showed that the risk factors of the hyperamylasemia's occurrence were LA,PCT, BG,PCIS<80,MODS>3.Adjusted ORs confidence intervals of them were 1.662 (1.236-2.234),1.042 (1.025-1.060),1.612 (1.411-1.843),3.219 (1.311-7.905),3.411 (1.370-8.494),respectively. The hyperamylasemia's prognostic risk factors were PCT,C-peptide,PCIS ≤80,MODS >3,shock. Adjusted ORs confidence intervals of them were 1.066(1.021-1.113),1.437(1.017 ~2.030),16.137 (1.876-138.836),10.437(1.528-71.925),20.928(1.938-226.009),respectively.Conclusions The severity of the disease,the levels of LA,PCT,BG in critically ill children were positively correlated to the occurrence of hyperamylasemia.The severity of the disease,the incidence of organ failures,the levels of PCT,C-peptide combined shock in children with hyperamylasemia were positively correlated to the prognosis of hyperamylasemia.

Objective To analyze the clinical features of critically ill children with abnormal pancreatic ultrasound findings in order to explore the related risk factors for offering evidence-based diagnosis of pancreatic damage secondary to critical illness.Methods A prospective study was performed in 531 critically ill children admitted to pediatric intensive care unit(PICU) of 17 children' hospitals from January 2012 to March 2014.All patients were divided into control group(513 cases) and abnormal group(18 cases) according to the pancreatic ultrasound findings.Comparison of clinical features and biochemical indicators were made between two groups.The related risk factors associated with abnormal pancreatic ultrasound findings were analyzed by using Logistic regression analysis.ROC curves were used to evaluate the role of amylase and lipase in the diagnose of abnormal pancreatic ultrasound findings.Results The incidence of abnormal pancreatic ultrasound findings in critically ill children was 3.39%, the average age of abnormal group was significantly older than that in control group (P<0.01).There were not statistically significant differences in gender and primary disease between two groups.The incidence of hypotension was 22.2% and the incidence of abdominal muscle tension was 16.7% in abnormal group,which were statistically higher than those in control group (P<0.05).The levels of calcium, albumin of abnormal group were significantly lower than those in control group (P<0.01), and levels of serum amylase, lipase, lactate dehydrogenase in abnormal group were significantly higher than those in control group (P<0.01).The risk factors associated with abnormal pancreatic ultrasound findings were age, blood pressure, calcium,amylase.Area under the ROC curve of abnormal pancreatic ultrasound findings determined by amylase and lipase were 0.803 and 0.745,respectively (P<0.05).The sensitivity was 0.667, specificity was 0.881 when the serum amylase was 101.5 U/L, the sensitivity was 0.722, specificity was 0.928 when the serum lipase was 96.9 U/L.Conclusions The incidence of abnormal pancreatic ultrasound findings was rather low in critically ill children.The risk factors associated with abnormal pancreatic ultrasound findings were hypotension, hypocalcemia, and hyperamylasemia.The elevated serum amylase and lipase might be the most likely factors associtaed with abnormal pancreatic ultrasound findings.

Objective To comment the severity of severe hand,foot and mouth disease(HFMD)by pediatric risk of mortality score(PRISM),and assess the performance of PRISM in predicting mortality or complication probability in HFMD.Methods Four hundred and twenty-four severe HFMD pediatric patients were recruited in the study from 1th Jan 2010 to 31th June 2013.Information on the outcome and the varia-bles required to calculate PRISM score were collected.The logistic regression model developed in the learning sample was evaluated in the test sample by calculating the area under the receiver operating characteristic (ROC)curve to assess discrimination pneumorrhagia and death.Calibration across deciles of risk was evalua-ted using the Hosmer-Lemeshow goodness-of-fit χ2 test.Results The area under the ROC curve were 0.87 (95%CI 0.80~0.94 )for PRISM in predicting pneumorrhagia probability.The area under the ROC curve were 0.87(95%CI 0.80~0.95)for PRISM in predicting mortality probability.The PRISM in observed and expected pneumorrhagia did not demonstrate good calibration at ten mortality risk intervals (χ2 =36.66, P<0.001 ).The PRISM in observed and expected mortality did not demonstrate good calibration at ten mortali-ty risk intervals(χ2 =41.11,P<0.001).Conclusion The PRISM score is demonstrated good discrimination of pneumorrhagia and death in HFMD pediatric patients,but the performance of calibration is not good.

Objective To investigate the prognostic value of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with sepsis.Methods A total of 162 patients was enrolled with consecutive pediatric intensive care unit (PICU) admissions during the study period of Jan 1st,2013 to June 30th,2013 at Hunan Children's Hospital.The 162 septic patients were divided into sepsis group and severe sepsis group,sepsis group and septic shock group,and survival group and death group.NT-proBNP was tested in the first and third day after 162 septic patients in hospital.Pediatric critical illness score (PCIS) score was assessed in all patients.NT-proBNP was compared between groups.The change of NT-proBNP was summarized between groups.The relationship between NT-proBNP and PCIS was analyzed.Results (1) The plasma NT-proBNP level of the first day after admission in the severe sepsis group and septic shock group was higher than sepsis group,the PCIS in the sepsis group was higher than severe sepsis group and septic shock group,with significant difference (P ＜ 0.05).(2) The plasma NT-proBNP level of the first day after admission in the death group was higher than the survival group,the PCIS in the death was lower than the survivor group,with significant difference (P ＜ 0.05).In the death group,the plasma NT-proBNP level of the third day after admission was higher than the NT-proBNP of the first day after admission (P =0.037) ; contrarily,the plasma NT-proBNP level of the third day after admission was lower than the NT-proBNP of the first day after admission in the survival group (P =0.023).Conclusions NT-proBNP could be used to assess the condition of septic patients,and dynamic test NT-proBNP can help to predict septic patient’s prognosis.

Objective To evaluate the early diagnosis value of serum cystatin C in the pediatric intensive care unit (PICU) children with septic acute kidney injury.Methods A total of 196 children in PICU confirmed with sepsis in Hunan Province Children's Hospital was enrolled in this study.Patients were divided into acute kidney injury (AKI) and non-AKI group according to whether accompanied with acute kidney injury.The serum cystatin C and serum creatinine were collected in 2 h,48 h,and 96 h after admission,and the clinical data were collected.The serum Cys C was drawn in receiver operating characteristic (ROC) curve.The sensitivity and specificity of Cys C were evaluated in diagnosis of septic AKI.Results The incidence of septic AKI was 35.20％,higher Cys C levels were risk factors for the onset of AKI,and OR was 26.218 (95％ CI:6.235 ～ 110.232).In AKI group,the serum Cys C level in 2 hours after admission was (2.05 ± 0.90)mg/L,which was higher than 48 hours (1.72 ± 0.72)mg/L and 96 hours (1.62 ±0.95) mg/L(Z =2.169,P =0.030; Z =2.789,P =0.005).In the septic AKI group,cystatin C and creatinine were positive correlation (r =0.582,P =0.000).The area under the ROC curve at 2hours after admission for serum cystatin C in diagnosis of AKI was 0.831.A cutoff point of 1.325 mg/L for 2 hours after admission was identified for cystatin C in the diagnosis of septic AKI,with a sensitivity of 87.1％and specificity of 78.9％.Conclusions Higher level of Cys C was risk factor for the onset of AKI.Compare to creatinine,cystatin C was earlier increased in children with septic AKI and positively correlated with it.It might be a biomarker for early diagnosis of septic AKI in PICU critical ill children.

Objective To evaluate the clinical value of N-terminal pro brain natriuretic peptide (NT-proBNP) in septic children with myocardial damage.Methods From Jan 1 to Jun 30,2013,162 children confirmed with sepsis in PICU of Hu'nan Children's Hospital were enrolled in the study.Patients were divided into myocardical injury and non-myocardical injury group according to whether accompanied with myocardial injury.NT-proBNP,lactate dehydrogenase,creatine kinase isoenzyme (CK-MB),troponin Ⅰ (cTnⅠ),myoglobin(MB) of patients were measured within 24 h after admission.The NT-proBNP level between two groups was compared.The correlations between NT-proBNP and cTnⅠ,CK-MB were studied respectively.Results The NT-proBNP level[M(Q)] in myocardial injury group[3 632 (668.5,15 453.5) pg/ml] was higher than that in non-myocardial injury group[349 (169,1 500) pg/ml],which was significantly different(Z =91.881,P =0.000).The levels of NT-proBNP,CK-MB,cTnⅠ,MB were abnormal distributions.There were positive correlations between logNT-proBNP and logCK-MB (r =0.367,P =0.000),logcTnⅠ(r =0.304,P =0.001) and logMB (r=0.302,P =0.000).NT-proBNP value of 1 163 ng/ml had a sensitivity of 76％ and a specificity of 74％ to diagnose myocardial injury.Conclusion NT-proBNP could help to diagnose sepsis with myocardial damage.

Objective To evaluate the effect of comprehensive control of schistosomiasis along the Xinglong River in Qianji?ang City so as to provide the evidence for improving schistosomiasis control. Methods The comprehensive control measures including infection source control and Oncomelania hupensis snail eradication were surveyed along the Xinglong River in Qianji?ang City. Results The prevalence of schistosomiasis was under control that was the human and cattle infection rates decreased by 53.77%and 100%respectively the snail area decreased by 26.9% the mean density of living snails decreased by 25.5%and no infected snails was found. Conclusions The comprehensive control measures along the Xinglong River are effective and the management and surveillance of snail environments still should be strengthened.

Objective To analyse the relationship between insulin resistance and the pancreatic beta cell dysfunction in critically ill children with hyperglycemia,to investigate the relationship between the pancreas injury and pancreatic beta cells dysfunction.Methods Seven hundred and thirty-six critically ill children admitted in PICU of Hunan Children's Hospital from Nov 2012 to Mar 2013 were reviewed and analyzed.According to the maximum intravenous blood glucose within 24 h after admission,they were divided into severely elevated group (blood glucose ≥11.1 mmol/L,n =67),slightly elevated group(blood glucose 6.1 ～ 11.1 mmol/L,n =361) and control group (blood glucose ≤ 6.1 mmo/L,n =308).Serum insulin,C peptide,serum amylase,lipase,urinary amylase,HOMA-β,HOMA-IR were compared among 3 groups.According to the severity of sepsis,they were divided into non-sepsis group (n =414),sepsis group (n =237),severe sepsis group (n =64),septic shock group (n =21).Blood glucose,serum insulin,C peptide,HOMA-βand HOMA-IR were compared among 4 groups.Results (l)The levels of insulin,C peptide,blood amylase,lipase and urine amylase were gradually increased with elevated blood sugar(rs =0.235,P ＜ 0.05;C =0.142,P ＜ 0.05 ; rs =0.142,P ＜ 0.05 ; rs =0.119,P ＜ 0.05 ; r.s =0.093,P ＜ 0.05).The differences among 3 groups were significant (P ＜ 0.05).The levels of serum amylase (IU/L) [102.81 (10.48-191.69)],lipase(U/L) [69.75(10.67-121.85)] were higher than upper limit of normal in severely elevated group.HOMA-β fell to 18.75％ in severely elevated group.The level of HOMA-β was decreased with the increase of blood sugar level (rs =-0.108,P ＜ 0.05).The level of HOMA-IR was increased with the elevated blood sugar level(rs =0.455,P ＜ 0.05).(2) The levels of blood glucose,insulin,C peptide and HOMA-β were significantly different among 4 groups of non-sepsis,sepsis,severe sepsis and septic shock group (P ＜ 0.05),HOMA-IR showed no significant difference among 4 groups (P ＞ 0.05).The levels of blood sugar increased to 9.21 (6.21-19.60) mmol/L,HOMA-β declined to 10.52％ in septic shock group,and blood glucose,insulin,C peptide,HOMA-β were significantly different compared with the other 3 groups (P ＜ 0.05).Conclusion Hyperglycemia is associated with insulin resistance and pancreatic β cells dysfunction in critically ill children,the cause of beta cell dysfunction is secondary to pancremic injury.Pancreatic beta cells dysfunction inducing hyperglycemia is more significant than insulin resistance in sepsis children.