Constipation is a common clinical symptom caused by different pathological and physiologi-cal factors.Because children are different age,the main reason for constipation is also different.The analysis should be carried out by different age groups.The cause and characteristic of constipation in different age child-hood are further explored and analyzed in the article in order to provide reference for diagnosis and to help treat-ment.

Abdominal pain is one of the common symptoms in children with diseases.Acute abdominal pain accounts for some parts of all primary presenting diseases in the emergency department.The clinical features and treatments of fulminant myocarditis,Henoch-Schonlein purpura and diabetic ketoacidosis initially presented with abdominal pain in children were reviewed in the article.

Objective:To investigate the Prostaglandin E2(PG-E2),Leukotrienes B4(LT-B4)、Platelet activating factor(PAF) and vascular endothelial growth factor (VEGF) levels in the model of UC rats serum,and the changes after the Mesalazine,clostridium, and montmorillonite powder treatment intervention ,in order to understand the significance of the four inflammatory factors in UC rats and the interference effect of the above three drugs on the four inflammatory cytokines .Methods:100 rats were randomly divided into normal group(A),model group(B),Mesalazine group(C),clostridium group(D)and montmorillonite group(E),The levels of the plasma PG-E2,LT-B4,PAF and VEGF were measured by ELISA .The different changes of the four cytokines were compared in the different groups.Results:①The scores of DAI and the levels of the plasma PGE2,LTB4,PAF and VEGF in the B,C,D and E group were higher than ones in A group(P<0.05).②Compared B group,the scores of DAI and the levels of plasma PGE2,LT-B4,PAF and VEGF in B,C,D and E group were lower ( P<0.05 ) .③Compared the efficacy among mesalazine , clostridium and montmorillonite powdergot treating UC , mesalazine and montmorillonite powder got the best results ( P<0.05 ) .The efficacy between mesalazine and montmorillonite was similar.Conclusion:①The PGE2,LT-B4,PAF and VEGF are very active higher in the blood of rats with UC and have a positive correlation with inflammation .②Mesalazine, clostridium and montmorillonite powder may renovate the damage of inflammatory tissues of rats with UC , and relieve the symptoms of inflammation , and also shorten the duration of inflammation by reducing exudation of proinflammatory cytokines PGE 2,LTB4,PAF and VEGF.

Objective To observe the clinical curative effect of phentolamine in the treatment of severe hand-foot-mouth disease (HFMD) . Methods We observed the clinical symptoms and related index changes before and after treatment of 62 cases of severe HFMD patients who were treated by the basis of conventional therapy with additional phentolamine. The blood pressure of patients was closely monitored,and the dosage of phentolamine was adjusted. Result The blood pressure and heart rate of sick children who used phentolamine improved significantly, the difference was statistically significant ( <0.05) . Conclusion Phentolamine has significant clinical curative effect in treatment of server HFMD.

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.

Objective To explore whether ginsenoside Rg1 can attenuate ?-amyloid peptide 25-35-induced Tau hyperphosporylation in rat embryo cortical neurons by regulating the activity of GSK-3? and PP2A. Methods Primary cultures of cortical neurons were prepared from the embryonic day 18?2 in Sprague-Dawley rats. The experimental groups were designed as follows:1.Neurons culture (control group); 2. Neurons exposed to 20?mol/L A?_ 25-35 for 12 hours (A?-model group); 3.Neurons exposed to 20?mol/L A?_ 25-35 and 10 mmol/L lithium chloride (LiCl), a specific inhibitor of glycogen synthase kinase-3?(GSK-3?), for 12 hours (LiCl group); 4.Neurons exposed to 20?mol/L A?_ 25-35 for 12 hours in the presence of 24-hour pretreatment with ginsenoside Rg1 (Rg1 pretreatment group) . Western blotting and immunocytochemical staining were used to detect the levels of Tau phosphorylation,total Tau and GSK-3? in cortical neurons. Non-radioimmunoassay was introduced to detect the activity of protein phosphatase 2A (PP2A). Results In A?-model group, the levels of Tau protein phosphorylation in the sites of Ser 396 ,Ser 199/202 ,Thr 231 and total Tau were enhanced. Meanwhile, the expression of GSK-3? was also increased, but the activity of PP2A was unchanged. In LiCl group and Rg1 pretreatment group , the hyperposphorylations of Tau protein and total Tau and the expression of GSK-3? were markedly reduced compared to those of the A?-model group (P

Objective To investigate Helicobacter pylori(Hp)infection and HLA-DQA1 allelic frequency in family members of children with recurrent abdominal pain.Methods One hundred and eighteen family members of 20 children with recurrent abdominal pain were divided into two groups:with and without recurrent abdominal pain.Serum Hp antibody was tested by dot immunogold filtration assay and immunophenotyping was determined by Western blot(immunobiot)technique.Polymerase chain reactionsequence specific primers(PCR-SSP)technique Was applied to identify HLA-DQAi allelic frequencies.Hardy-Weinberg equilibrium test was performed(P>0.05),and Chi-square test was used to compare the frequency of HLA-DQA1 alleles between the groups.Results The Hp seropositive rate in 118 members Was 100%and the Hp immunophenotyping was 96.6%.The prevalence of Hp Ⅰ and Ⅱ type was 55.1%(65/118)and41.5%(49/118).HLA-DQA1*0302 allelic frequency Was significantly higher in subjects with recurrent abdominal pain than that in subjects without one(23%vs.2%,X2=13.277,P=0.000).Conclusion There is immunogenetic difference between familial members with and without recurrent abdominal pain infected by Hp,and HLA-DQA1*0302 may be the associated gene contributing to different clinical outcomes after Hp infections.

Objective To evaluate the prognostic value of hyperintense vessel (HV) in patients with acute middle cerebral artery (MCA) occlusion.Methods Seventy-four consecutive patients with first ever stroke(48 male and 26 female,the mean age was (60.7 ± 15.3) years) in the territory of MCA,retrieved from Nanjing Stroke Registry Program between May 2009 and February 2011,were enrolled assubjects.All subjects completed brain MRI,and MRA or DSA indicated proximal MCA occlusion.According to the location and extent of HV,all subjects were classified into 3 groups:without HV,proximal HV and distal HV.Clinical data were obtained and compared among patients with different grades of HV.Logistic regression analysis was employed to confirm the relevant factors of prognosis 90 days after index stroke.Results HV was observed in 49 (66.2％ ) of the 74 enrolled patients.Among patients with HV,7 (9.4％ ) were classified as proximal HV and 42 ( 56.8％ ) as distal HV.Initial NIHSS score ( 11 ( 1 -22) ),10-day NIHSS score ( 13.5(4-25) ),infarction size ( ＞2/3:5 cases(6.8％ ) ),and 90-day mRSscore (3-6 scores:12 cases( 16.2％ )) were significantly lower in patients with distal HV than those without (15(6-25),Z=-3.544;7(0-22),Z=-4.461;20 cases(27.0％),x2 =20.916;27 cases (36.5％),x2 =22.689;all P＜0.01).The NIHSS score decreased from baseline to that on 10 days and the mRS score decreased from 10 days to that on 90 days in patients with distal HV was more than that in patients without distal HV. Multivariate analysis revealed that patients with older age ( OR =1.111,95％ CI 1.036-1.191,P=0.003),high infarction size (OR=3.679,95％ CI 1.35-10.025,P=0.011) worsened outcome,whereas distal HV (P =0.012,OR =0.131,95％ CI 0.027-0.638)improved outcome.Conclusion Distal HV on FLAIR may predict a favorable outcome in patients with acute middle cerebral artery occlusion.

Objective To investigate the value of hyperintense vessel signs (HVS) on fluidattenuated inversion recovery (FLAIR) sequence for assessing the patterns of collateral blood flow in adult moyamoya disease (MMD).Methods Forty-one adult patients with non-hemorrhagic MMD retrieved from Nanjing Stroke Registry Program between August 2008 and January 2011 were identified by digital cerebral angiography and performed the examination of FLAIR sequence in Jinling hospital.According to the different sites of HVS located in the territory of the middle cerebral artery,the patterns of HVS were classified into grades 0-3: Grade 0,absence of HVS ; Grade 1,HVS limited in the cerebral sulci of temporal lobe and Sylvian fissure ; Grade 2,HVS in the cerebral sulci of frontal and parietal lobe regions and Sylvian fissure;and Grade 3,HVS in the combined territories of Grade 1 and Grade 2.According to the intracerebral collateral blood flow,steno-occlusions of the arteries were classified into three types: Type 1,residual antegrade flow across steno-occlusive lesions; Type 2,retrograde flow via leptomeningeal vessels; Type 3,the combined collateral blood flow of Type 1 and Type 2.The relationship between the patterns of intracerebral collateral blood flow and the location of HVS was analyzed.Results Of 41 adult patients with non-hemorrhagic MMD,there were 3 patients presented with unilateral vascular lesions and 38 with bilateral vascular lesions,so the total number of vascular lesions of the cerebral hemispheres was 79.Because three patients showed the absence of HVS in bilateral hemispheres,the total number of the presence of HVS of the cerebral hemispheres was 73.Therefore,the percentage of the presence of HVS was 92.4％ (73/79) in vascular lesions of the cerebral hemispheres.Importantly,the patterns of slow collateral blood flow corresponding to Grade 1 HVS were all antegrade (7/7) ; the collateral patterns corresponding to Grade 2 HVS were mainly retrograde leptomeningeal flow (95.0％,19/20) ; and the patterns corresponding to Grade 3 HVS were mainly slow combined collateral blood flow(84.8％,39/46).Furthermore,with the changing sites of HVS from the cerebral sulci of temporal lobe to the cerebral sulci of frontal and parietal lobe regions,the directions of collateral flow changed with a shift from antegrade to retrograde,which was statistically significant.Conclusion The different locations of HVS can reflect the different patterns of collateral blood flow,and the locations of HVS may predict the directions of intracerebral collateral blood flow in adult MMD patients.

Objective To study the changes of plasma gastrin (Gas), substance P (SP) and vascoactive intestinal peptide (VIP) among children with recurrent abdominal pain and their family members,and to explore if there is the rule of the changes.Methods The fasting plasma Gas, SP and VIP were determined by radioimmunoassay method among 30 children with recurrent abdominal pain, and 45 family members including first-degree relatives and second-degree relatives as well as 35 normal healthy children and 20 normal healthy adults. Individuals were divided into five groups:children with recurrent abdominal pain (study group 1), family members with recurrent abdominal pain (study group 2), normal healthy children (control group1), family adults without recurrent abdominal pain (control group2) and normal healthy adults (control group3) . The whole family members of 7 children with recurrent abdominal pain were focused on and analysed.Results 55 of 130 volunteers were with recurrent abdominal pain including 30 children and 25 adults. There were 22 adults with and 20 adults without recurrent abdominal pain in the whole family members of 7 children with recurrent abdominal pain. The fasting plasma Gas content had no difference between study group 1 and control group1 ( <0.05), but the levels of fasting plasma SP and VIP were both in decrease and had difference between study group 1 and control group1 (<0.05) .The fasting plasma Gas,SP and VIP had no difference between study group 2 and control group 2 ( >0.05) .The levels of fasting plasma Gas content had no difference between study group 2 and control group 3 (>0.05),but the levels of fasting plasma SP and VIP were both in increase and had difference between study group 2 and control group3. The fasting plasma Gas content had no difference between country group 1 and control group3 ( <0.05),but the levels of fasting plasma SP and VIP had difference between country group 1 and control group3 ( <0.01) .The levels of fasting plasma SP and VIP had no difference between study group 1 and study group 2 ( <0.05) .The levels of fasting plasma Gas, SP and VIP content had no difference among the whole family members of 7 children with recurrent abdominal pain including 22 adult members with and 20 adult members without recurrent abdominal pain (>0.05) .Conclusions There are the same plasma Gas contents in normal children and adults.However, the plasma SP and VIP contents are higher in normal children than ones in normal adults. The plasma SP and VIP contents are lower in children with recurrent abdominal pain than ones in normal children. The plasma SP and VIP contents are higher in adults with recurrent abdominal pain than ones in normal adults. These suggested that the increases of plasma SP and VIP may have a close relationship with the pathogenesis of children and adults with recurrent abdominal pain. The contents of plasma Gas, SP and VIP were consistent in the whole family members of 7 children with recurrent abdominal pain. It suggested that the secretion of gastrointestinal hormone is disorder in the families with recurrent abdominal pain.