Objective To investigate the the curative effect of pidotimod combined with Yanhuning for children with refractory mycoplasma pneumonia(RMPP).Methods90 patients with RMPP from January 2013 to January 2015in shengzhou maternal and child health care hospital were divided into 3 groups, including Yanhuning group(A group), azithromycin combined with Yanhuning group(B group)and pidotimod combined with Yanhuning group(C group).And the total effective rate, the clinical symptoms, immune function parameters were analyzed.ResultsThe regulation of immune function in C group was more significant than that in A group and B group, the prognosis was better, and the repeated times and continuous time were decreased (P<0.05).ConclusionPidotimod combined with Yanhuning treatment of RMPP can regulate the immune function of children, improve clinical symptoms, it is worthy of popularization.

Objective To investigate the protective effects of different ATP-sensitive potassium (K_ ATP) channel openers. Pinacidil and Diazoxide, on myocardium injury in isolated rabbit hearts caused by ischemia/reperfusion and the possible changes after application of ATP-sensitve potassium channel blocker, 5-HD. Methods Observation was made on rabbit hearts perfused with a Langendorff apparatus. Forty rabbits were randomly divided into five respective groups: 1. Pinacidil (Group P), 2. Diazoxide (Group D), 3. 5-HD+Pinacidil (Group HP), 4. 5-HD+Diazoxide (Group HD) and 5. the control (Group C). All groups were subjected to 40 minutes of occlusion, followed by 20 minutes of reperfusion as cardiac arrested by cold cardioplegia. Any one of Pinacidil, Diazoxide , Pinacidil or Diazoxide mixed with 5-HD was infused 15 minutes before cardioplegic heart rested in the experimental group. Cardiac tissue ultrastructure, hemodynamics variables, levels of adenine nucleotides and lipid peroxide of the myocardium were measured. Results (1) In Group P, Group D and Group HP, the recovery of myocardial contractility and heart rate after reperfusion was faster but MDA level and the amount of albumen released were lower than Group C. Moreover levels of myocardial adenosine triphosphate (ATP) were much higher compared with Group C. (2) In Group HP the recovery of myocardial contractility and heart rate was not as good as Group P, but its myocardium MDA level and amount of albumen released was higher than group P. Conclusion ATP-sensitive Potassium Channel openes may enhance myocardial protection against ischemia /reperfusion injury. The above effect of myocardial protection was only partially closed down by ATP-sensitive potassium channel blocker: 5-HD. The mitoK_ ATP channels on myocardium may be an important pathway of protection during ischemia/reperfusion process.

Objective To investigate whether Shenfu(SF) injection has protective effect on circulation function in infants undergoing cardio-pulmonary bypass.Methods Thirty-six patients within 3 years old with congenital heart disease were randomly divided into SF injection group(n=18) and control group(n=18).The SF group were treated with 1 mL/kg SF intravenous injection after inducing of anesthesia,the control group were infused with 1 mL/kg saline intravenously.The changes of hemodynamics during surgery,time needed for sinus rhythm emerging on electrocardiogram(ECG) after arteriae aotra patency dose of vaso-active drugs intra-and postoperatively and recovery time during postoperative period were observed.Results In SF group,mean artery pressure(MAP) was higher and heart rate(HR),central venous pressure(CVP) lower than control group(P

Objective To evaluate the role of 5-HT5A receptors (5-HT5A R) in activation of astroglia in the spinal dorsal horn in a rat model of neuropathic pain induced by vincristine. Methods Forty adult male SD rats weighing 180-200 g were randomly divided into 4 groups ( n = 10 each): control group (group C);neuropathic pain group (group P);Ad-X-HK group (group B) and Ad-5-HT5A-siRNA group (group S). Neuropathic pain was induced by repeated intraperitoneal (IP) injection of vincristine 0.1 mg/kg according to the method described by Weng et al in group P, B and S. On the 2nd day after the last IP injection, the animals received artificial cerebrospinal fluid, Ad-X-HK and Ad-5-HT5A-siRNA 25 μl administered intrathecally (IT) in group P, B and S respectively. Paw withdrawal threshold to mechanical stimulus was measured before and on the 7th day after IT administration. The animals were then sacrificed. The lumbar segment ( L4.5 ) of the spinal cord was removed for determination of 5-HT5A R and GFAP expression. Results Body weight and paw withdrawal threshold were significantly decreased after repeated IP vincristine administration in group P compared with group C. IT Ad-5-HT5A-siRNA reduced pain threshold further in group S compared with group P. Repeated IP vincristine significantly increased the expression of 5-HT5A R and GFAP in spinal dorsal horn, and IT Ad-5-HT5A-siRNA significantly decreased the expression of 5-HT5A R while increased the expression of GFAP in spinal dorsal horn in group S compared with group P. Conclusion 5-HT5AR is involved in the inhibition of astrocyte activation, resulting in reduction of vincristineinduced neuropathic pain.

Objective To investigate intraoperative changes of internal environment in infants undergoing living related liver transplantation (LRLT), and to explore appropriate treatment measures. Methods Twenty-five infants undergoing LRLT were retrospectively studied, including 12 males, 13 females, with age of (3. 4 ± 4. 6) months (ranging from 2-11 months), weight of (6. 8 ±1. 3) kg (ranging from 3. 1-8. 8 kg). Arterial blood samples were collected before the operation, at preanhepatic phase (5 min before cross-clamping), at anhepatic phase (5 min before opening inferior vena cava), 5 and 30 min after the opening inferior yena cava respectively, and at the completion of the surgery the pH value, bases excess (BE), the levels of sodium, potassium, calcium, glucose and lactate were determined. Results There were large fluctuations to the internal environment during operation. Compared with the preoperative values, the intraoperative concentrations of Na+ had no significant change; The pH value and blood level of K+ had no significant change at pre-anhepatic phase and anhepatic phase (P＞0. 05), the pH value was decreased at anhepatic phase Ⅰ (P＜0. 01 )and returned to the preoperative level at the end of the operation, and the blood level of K+ decreased at anhepatic phase and lasted till the completion of the surgery (P＜0. 01 ). The blood level of Ca2+ was decreased at pre-anhepatic phase and neohepatic phaseⅡ (P＜0. 05), and recovered at the end of the operation. Blood glucose concentration was increased significantly at preanhepatic phase to neohepatic Ⅱ, and still kept at the higher level until the end of operation. The lactate concentrations were increased significantly at pre-an.hepatic phase to neohepatic Ⅱ (P＜0. 01 ), and recovered at the end of operation. The BE was decreased at pre-anhepatic phase to neohepatic Ⅱ (P＜0. 05), and recovered at the end of the operation. Conclusion There are significant disruptions which are unique and inter-related to the internal environment parameters in infants during the operation of LRLT.Monitoring and accurate intraoperative managements for different physiological status at different phases are critical for the success of LRLT in infants.

Objective To find a more suitable approach to pediatric anesthesia during laparoscopic operation to alleviate stress response.Methods Forty patients,1 to 3 years of age,ASA grade Ⅰ-Ⅱ,underwent general anesthesia(group GA)and combined general epidural anesthesia(group GEA)during their laparoscopic operation.Heart rate(HR),mean arterial pressure(MAP),ECG,SPO2,PETCO2,blood gas,plasma epinephrine,plasma norepinephrine,plasma IL-6 and IL-10 were monitered and recorded five minutes before anesthesia(T0),pre-pneumoperitoneum(T1),5 min after pneumoperitoneum(T2),30 min after pneumoperitoneum(T3),30 min after operation(T4)and 24 h after operation(T5).Results(1)HR,MAP of group GA were increased obviously at T2,T3,T4 compared to T0(P0.05).Significant difference was found at T1,T2,T3 and T4 between group GA and group GEA(t=4.749,10.349,13.632,10.051,P0.05).Plasma IL-10 at T1,T2,T3,T4 were higher than that at T0 in both groups(P

Objective To evaluate the efficacy and adverse effect of brachial plexus block with morphine and ropivacaine for postoperative analgesia in children. Methods Forty-five children undergone upper extremity surgery were randomly divided into three groups (n = 15) , ie, Croup A (brachial plexus block with ropivacaine), Croup B (brachial plexus block with ropivacaine and subcutaneous injection of morphine) and Croup C (brachial plexus block with morphine and ropivacaine). The analgesic effect and the analgesia maintenance time were recorded by FLACC method at 1, 2, 4, 6, 8, 12, 24 hours after operation. The adverse reactions were observed 48 hours after operation. Results There was no statistical difference between Croup A and Croup B in the analgesia maintenance time and the number of cases without analgesic therapy at each time point (P > 0. 05). Compared with Croup A or Croup B, the analgesia maintenance time in Croup C were significantly extended and the number of cases without analgesic therapy at 4, 6, 8, 12, 24 hours after operation were significantly increased (P < 0.05). The adverse effect was fairly light in three groups. Conclusion Brachial plexus block with morphine and ropivacaine may extend analgesia maintenance time effectively and safely in children undergone upper extremity surgery.

Objective To translate the English version of Infant Feeding & Nutrition Checklist For Congenital Heart Disease (IFNC:CHD) into Chinese,and to test the reliability and validity of the Chinese version of IFNC:CHD.Methods After obtaining authorization from the developer,the IFNC:CHD was translated and culturally adapted into Chinese version.The reliability and validity of the Chinese version of IFNC:CHD were tested in 168 patients.Results The Cronbach's α coefficient was 0.804.Two nurses used the scale to evaluate the consistency of the results,and the Kappa coefficient was 0.812.The content validity index of item ranged from 0.80 to 1.00,and the average index was 0.90 for the total scale.The correlations coefficients between each dimension score and the total score ranged from 0.339 to 0.474 (P＜0.01),and the correlations coefficients between each dimension score ranged from 0.198 to 0.861(P＜0.01,P＜0.05),Three factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 72.66％.Conclusion The Chinese version of IFNC:CHD has been proved to have good reliability and validity.It can be used to assess infant feeding and nutritional risk of congenital heart disease in the Chinese settings.

Background:Dysregulation of microRNA expression is involved in the carcinogenesis of many tumors,expression of miR-504 has been observed in many tumors,but its expression in primary hepatocellular carcinoma(HCC)has not been reported. Aims:To explore the expression and clinical significance of miR-504 in HCC tissues and cells. Methods:Tumor and para-cancerous tissue in 85 HCC patients were collected. Five liver cancer cell lines and immortalized liver cell line were conventionally cultured. Effect of miR-504 expression on HepG2 cells proliferation was determined by CCK8 assay. The expression of miR-504 was determined by real time fluorescent quantitative PCR. Relationships between expression of miR-504 and clinicopathological features and prognosis of HCC patients were analyzed. Results:Compared with normal liver cells,expression of miR-504 was significantly downregulated in five liver cancer cells(P < 0. 05). Up-regulation of miR-504 inhibited proliferation of HepG2 cells,and down-regulation of miR-504 promoted proliferation of HepG2 cells. miR-504 expression in tumor tissue was significantly decreased than that in corresponding para-cancerous tissue. Expression of miR-504 was correlated with tumor differentiation(P = 0. 002),TNM stage(P = 0. 021),alpha fetoprotein(P = 0. 012)and portal vein tumor thrombus(P = 0. 003),but not with gender,age,tumor size and tumor number. Survival in HCC patients with lower miR-504 expression was significantly shorter than that in patients with high expression(P < 0. 05). Conclusions:Expression of miR-504 is downregulated in HCC,and is correlated with the prognosis of patients,suggesting that miR-504 can be used as an independent predictor for prognosis of HCC patients.

Objective To study the effect and possible mechanism of diazoxide on myocardial ischemia/reperfusion (I/R) injury in diabetic rats, and the influence of insulin intervention which aims to maintain blood sugar levels within the normal range on the protective function of cardiomyocytes. Methods 126 health male Sprague-Dawley (SD) rats were intraperitoneally injected with one dose of 60 mg/kg streptozotocin (STZ) to reproduce diabetic model. The diabetic rats were randomly divided into seven groups, with 18 rats in each group. Myocardial I/R model was established by 30 minutes ligation of the left anterior descending branch of the coronary artery, and 120 minutes blood circulation recover. Sham group was only threaded without ligation. Rats in I/R group, diazoxide group (DZ group), and Ottawa vine penicillin (WNT) group were infused intravenously with 2 mL of 0.1% dimethyl sulphoxide (DMSO), DZ (7 mg/kg), and WNT (15 μg/kg), respectively, after 25 minutes of ischemia. Sham group was only injected with 2 mL of 0.1% DMSO. DZ+WNT group was infused with WNT 5 minutes before the injection of DZ. Insulin intervention (RI) group received a continuous insulin infusion to maintain the blood sugar at the level of 4-6 mmol/L. RI+DZ group was infused with DZ after ischemia for 25 minutes based on blood sugar control. Hemodynamic parameters in each group were monitored continuously. The pathological changes of myocardium were observed with hematoxylin and eosin (HE) staining. The expressions of phosphorylated protein kinase B (p-Akt) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β) were determined by Western Blot. Results Compared with sham group, the cardiac functions of the intervention groups were significantly decreased, and severe myocardial injury was observed. Compared with I/R group, the cardiac functions of intervention groups were not obviously improved. However, after insulin intervention by which blood sugar was maintained within normal range, the cardiac function and myocardial injury were further aggravated. Compared with sham group (the expression value of sham group was set as 1), the expressions of p-Akt in other groups including I/R group, DZ group, RI group, and RI+DZ group showed no statistically significant difference (gray value: 1.07±0.09, 1.03±0.07, 1.07±0.07, 1.02±0.08 vs. 1.00, all P > 0.05). However, the expressions of p-Akt were decreased in WNT group and DZ+WNT group as compared with those of sham group and I/R group (gray value: 0.54±0.06, 0.51±0.05 vs. 1.00 and 1.07±0.09, all P < 0.05). The expressions of p-GSK-3βshowed no statistically significant difference in I/R group, DZ group, WNT group, and DZ+WNT group as compared with sham group (gray value: 0.97±0.08, 1.00±0.11, 0.98±0.06, 0.97±0.09 vs. 1.00, all P > 0.05). However, the expression of pGSK-3β was increased in RI group, RI+DZ group as compared with sham group and I/R group (gray value: 1.68±0.08, 1.70±0.05 vs. 1.00 and 0.97±0.08, all P < 0.05), and it was significantly higher in RI+DZ group than that of DZ group (gray value: 1.70±0.05 vs. 1.00±0.11, P < 0.05). Conclusions Diazoxide after myocardial injury could not protect the myocardium from I/R injury in diabetic rats, and did not trigger the activation of the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Insulin intervention by which blood sugar was maintaine d within the normal range exacerbates myocardial I/R injury in diabetic rats.