Objectives To explore the change of interleukin-17 (IL-17) in Kawasaki disease (KD). Methods Fourty KD pediatric patients, among them 12 patients with echocardiographic abnormalities in acute phase, 25 age-matched non-KD patients were enrolled. The level of serum IL-17 was measured by enzyme linked immunosorbent assay in acute and convalescent phase of KD patients and non-KD patients. At the same time, C-reactive protein (CRP), globulin, albumin were detected. Results In acute phase of KD patients, the level of serum IL-17 were signiifcantly higher than that in convalescent phase of KD patients and non-KD patients (P<0.05). The level of serum IL-17 was no signiifcant differences in convalescent phase of KD patients and non-KD patients (P>0.05). In acute phase of KD patients with echocardiography abnormalities, the level of serum IL-17 was signiifcantly higher than that with non-echocardiography abnormalities (P<0.05). The level of serum IL-17 in acute phase of KD patients were positively correlated with CRP and globulin (r=0.750, 0.750, P<0.05), and negatively correlated with albumin (r=-0.779, P<0.05). Conclusions IL-17 may be involved in KD immune pathogenesis. Serum IL-17 is one of the activity index of KD, which associ-ated with cardiovascular damages.

Objective To investigate relationship between the variation degree of platelet mitochondria in rats with severe hemorrhagic shock and the degree of shock.Methods Thirty-six Wistar rats were divided into sham group,shock 30,60,and 120 minutes groups,shock 120 minutes + normal saline (NS) + blood reinfusion group (NS group) and shock 120 minutes + polydatin (PD) + blood reinfusion group (PD group) according to random number table,with six rats per group.Content of ATP in platelets was detected by fluorescein-luciferase assay kit; structure of platelet mitochondria by electron microscope; state of mitochondrial permeability transition pore by Calcein-AM and CoCl2 ; change of mitochondrial membrane potential (△Ψm) by JC-1 mitochondrial membrane potential kit; lipid hydroperoxide (LPO) in platelets by LPO assay kit; stability of platelet lysosomes by acridine orange (AO).Results ATP released from platelets was reduced significantly in shock 60 minutes group (P ＜0.01) and with the prolong of shock period,further reduction was observed,particularly in NS group [(50.75 ± 9.15)％ of normal value].Mitochondrial swelling with poorly defined crista structure,declined △Ψ and low lysosome stability (pale cells were increased) were observed in shock 30 minutes group.Calcein fluorescence in mitochondria was faded in shock 60 minutes group (P ＜ 0.01).Whereas in PD group,all the above indices presented some recovery with ATP level returned to nearly (79.57 ± 8.48) ％ of normal value in particular.Conclusions Platelet mitochondrial dysfunction takes place at 30-60 minutes following severe shock.Hence,it may be served as an non-invasive index for the diagnose and treatment of severe shock.

Objective To investigate the status and influencing factors of fear of falling (FOF) in patients with first ever cerebral infarction. Methods A sample of 105 inpatients with cerebral infarction were recruited from two tertiary hospitals in Tianjin (Tianjin Huanhu Hospital, the First Affiliated Hospital of Tianjin University of TCM) to complete this research. They were investigated with the simplified Chinese version of Falls Efficacy Scale International-short (FES-Is), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Barthel Index Rating Scale (BI) and Functional Ambulation Category Scale (FAC). Results The total score of FES-Is was 15.38±7.45. Multiple stepwise regression analysis showed that age, marital status, fall history, walking ability and anxiety were important factors of FOF. Conclusions Clinical staff should guide the patients with first cerebral infarction especially who had a history of falling to take active and effective measures to deal with their FOF, and pay more attention on patients who was elderly, without a spouse, assisted walking and anxiety, to release their FOF, prevent the falling and promote the functional recovery of patients.

BACKGROUND: The evaluation of stereoacuity can provide an unambiguous assessment of haplopia. It is valuable in assessing the diagnosticaccuracy and the therapeutic effect in strabismus, amblyopia and ametropia. OBJECTIVE: This investigation was designed to evaluate the stereopticdevelopment and the occurrence rate of strabismus in 3-6 years old children, and so that to provide objective data for prevention and treatment of strabismus and steropsis. DESIGN: It was a randomized sampling investigation. SETTING: Department of Ophthalmology,Haikou People's Hospital. PARTICIPANTS:Totally 8326 children in 25 urban and suburban kindergartens, with an age of 3-6 years old, were selected randomly in Haikou city from June 2000 to April 2002. METHODS: 8 326 3-6 years old children in Haikou city underwent vision examinations on hyperopia, eye position and the myopia. Those having eyesight lower than 1.0D or abnormal eye position received atropine drops to dilate the pupil of the eye for optometry. ① 4-6 years old children were examined using standard visual chart and logMAR chart (logarithm of the minimum angle of resolution chart), 3 years old children were examined using hroken wheel acuity cards or symbols chart. The results of the exminations were conversed and recorded in form of decimal fraction uniformly. ②The corneal reflection and the cover test procedure were used for the position of gaze. ③ Stereoacuity were examined using the stereoptic visual testing cards (made by the Institute of Biophysics, Chinese Academy of Sciences). Stereoacuity were defined as normal when the test value was ≤ 60 s and were defined as abnormal when it was ≥ 100 s. Each examination was performed by same selected physicians. MAIN OUTCOME MEASURFS: The main outcome measurements included ① results of eye position examination and stereoptic examination in children in all age brackets, ② results of optometry in children with strabismus, ③ The relation between eyesight and stereopsis in participants,④Stereoacuity of children in all age brackets, ⑤and possible causations involve in stereopsis. RESULTS: Practically, 8326 participants receiving examinations of eysight and eye position entered the statistical analysis procedure, while an other 662 children were omitted for their poor expression for the examinations. ① Results of stereoptic examination and eye position examination for participants in all age brackets: 165 (2％) with strabismus, in which 89.7％were first diagnosed; 2016 (27.5) with myopia, whose stereoptic value were ≥ 100 s. ②Results of optometry in children with strabismus: 93.5％ esotropia occurred in children with hyperopia. The rate of hyperopia/myopia was not significantly different between exotropia and vertical strabismus.③ Relation between eyesight and stereoacuity of participants: 75.5％ children have a normal stereoacuity.With a decreasing in eyesight,the stereoacuity decreased (P ＜ 0.05 or P ＜ 0.01). ④ Stereoacuity of the children in all age brackets: With an increasing age, the rate of children with normal stereoacuity increased. ⑤ Possible causations involved in stereopsis: strabismal amblyopia might have the greatest influence on stereopsis. CONCLUSION: ①About 90％ children with strabismus were firstly diagnosed in the investigation. Causations responsible for abnormal stereopsis include ametropia, strabismus, and amblyopia, and so on. ② Concomitant esotropia has close relation with binocular accommodation, while exotropia and vertical strabismus are not linked to refractions. Stereoacuity decreases with a decreasing in eyesight. ③ The results of the investigation support the view that mature stereopsis is achieved early than 4 years old although certain variance of stereoptic development can be observed among individuals.

Objective To observe the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP),high density lipoprotein cholesterol (HDL-C) in predicting cardiovascular damage in Kawasaki disease (KD).Methods Enzyme-linked fluorescence analysis (ELFA) technique was used to measure serum NT-proBNP levels in 406 KD patients [including 104 cases of incomplete Kawasaki disease (IKD)] at the acute phase,the convalescent stage,at the same time,the blood HDL-C,Albumin,globulin,alanine aminotransferase (ALT),C-reactive protein (CRP),red blood cell sedimentation rate (ESR),blood white cell count (WBC),hemoglobin (Hb),blood platelet count (PLT) level were tested.According to the results of echocardiography,electrocardiogram,myocardial enzymes in KD,patients were divided into two groups:two hundred and twenty-two with cardiovascular damage and 184 without cardiovascular damage group.The age,gender,fever,the first application of the intravenous gamma globulin,laboratory markers of clinical features observed above the detection levels were compared,and these parameters for each group were compared using t test or analysis of variance,the single factor which was statistically significant were received operating characteristic curve (ROC) analysis.Then the cardiovascular damage group was divided into echocardiography abnormal group and echocardiography normal group,and t test was adopted to compare the clinical parameters of the two groups.Results ① The age,lip and oral changes,the first application of intravenous gamma globulin,blood NT-proBNP,HDL-C,albumn and ALT was significantly different between the cardiovascular damage group and non cardiovascular damage group (t/x22=4.989,4.721,6.212,18.834,12.788,4.851,4.541,All P＜0.05).② When the blood NT-pro-BNP was higher than 786.5 ng/L,its sensitivity and specificity for differentiating KD with cardiovascular damage was 86.5％ and 84.8％,respectively.When the blood HDL-C was lower than 0.655 mmol/L,its sensitivity and specificity for differentiating KD with cardiovascular damage was 80.4％ and 69.4％ respectively.When the blood NT-proBNP was higher than 786.5 ng/L in addition to HDL-C lower than 0.655 mmol/L,the specificity for differentiating KD with cardiovascular damage was 91.8％.③ For the 222 cases with cardiovascular dam-age,their blood NT-proBNP,HDL-C levels were statistically significantly different between the echocardiogra-phy abnormal group and echocardiography normal group (t=3.354,4.084,All P＜0.05).④ The serum NT-proBNP,ALT levels of the 406 acute and convalescent KD patients were significantly higher than the recovery phase.The blood HDL-C,albumin level of acute patients were significantly lower than those at the recovery phase,the difference was statistically significant (t=22.335,4.951,20.334,15.073,All P＜0.05).⑤ One hundred and four children with IKD were divided into patients with cardiovascular damage (74 cases) and without cardiovascu-lar damage (30 cases),the age,lip and oral changes,the first application of intravenous gamma globulin,blood NT-proBNP,HDL-C,albumin and ALT were significantly differentbetween these two groups (t=3.083,2.157,6.423,6.409,3.649,8.658,All P＜0.05).Conclusion Blood NT-proBNP and HDL-C are good pre-dictive parameters in children with cardiovascular damage of KD,IKD.

Objective A prospective randomized controlled trial was carried out to explore the best time of In-domethacin suppositories administration for the prevention of post-ERCP pancreatitis in high-risk groups. Methods 81 patients were enrolled in the study finally. Patients were randomized into group A (100 mg rectal Indomethacin suppositories was administrated immediately after ERCP), group B (100 mg rectal Indomethacin suppositories was administrated half an hour after ERCP) and group C (ERCP alone group, which did not give Indomethacin supposito-ries). The level of serum amylase, urine amylase, serum CRP, serum IL-6, serum TNF-α were measured before, 3 h, 24 h and 48 h after ERCP, and the incidence of PEP and hyperamylasemia were analyzed. Results There was 1 case (4.00%) of PEP in group A, 2 cases (5.41%) of PEP in group B and 5 cases (26.31%) of PEP in group C;the incidences of PEP of group A and group B were significant lower than that in group C (P < 0.05). There was 1 case (4.00%) of hyperamylasemia in group A, 5 cases (13.51 %) of hyperamylasemia in group B and 6 cases (31.6 %) of hyperamylasemia in group C, and the incidences of hyperamylasemia of group A and group B were significant lower than that in group C ( P< 0.05). Conclusion Administration of 100 mg Indomethacin suppositories immediately or half an hour after ERCP can effectively reduce the incidence of PEP and hyperamylasemia.

To explore the correlation of mid-term oral glucose tolerance test (OGTT) and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). A total of 2611 pregnant women with GDM who were examined and delivered in Women's Hospital, Zhejiang University School of Medicine from July 1st 2017 to 30th June 2018 were enrolled in this study. According to the number of abnormal items of mid-term OGTT results or maternal gestational weight gain (GWG), patients were classified. The incidence of adverse perinatal outcomes in each group and its relation with OGTT results and GWG were analyzed. The incidence of gestational hypertension, premature delivery, macrosomia and large for gestational age infant (LGA) in three abnormal items GDM patients were significantly higher than those in one or two abnormal items GDM patients (all <0.017). The incidence of gestational hypertension and premature delivery in two abnormal items GDM patients were higher than those in one abnormal item GDM patients (all <0.017). The incidence of gestational hypertension and macrosomia in excessive GWG patients were significantly higher than those in inadequate and appropriate GWG patients (all <0.017), and the incidence of LGA were higher than that in inadequate GWG patients (all <0.017). The incidence of premature delivery and low birth weight infants in appropriate GWG patients were significantly lower than those in inadequate and excessive GWG patients, and the incidence of small for gestational age infant (SGA) were significantly lower than that in inadequate GWG patients (all <0.017). In one abnormal item GDM patients, inadequate GWG was a risk factor for premature delivery and SGA (=1.66, 95%: 1.10-2.52; =2.20, 95%: 1.07-4.53), and protective factor for LGA (=0.40, 95%: 0.27-0.59). And excessive GWG was a risk factor for gestational hypertension, premature delivery and low birth weight infants (=2.15, 95%: 1.35-3.41; =1.80, 95%: 1.20-2.72; =2.18, 95%: 1.10-4.30).In two abnormal items GDM patients, inadequate GWG was a protective factor for macrosomia and LGA (=0.24, 95%: 0.09-0.67; =0.54, 95%: 0.34-0.86), while excessive GWG was risk factor for premature delivery (=1.98, 95%: 1.23-3.18).In three abnormal items GDM patients, there was no significant relationship between GWG and adverse pregnancy outcomes. For GDM women with one or two items of elevated blood glucose in OGTT, reasonable weight management during pregnancy can reduce the occurrence of adverse pregnancy outcomes. For those with three items of elevated blood glucose in OGTT, more strict blood glucose monitoring and active intervention measures should be taken in addition to weight management during pregnancy.
Blood Glucose ; Blood Glucose Self-Monitoring ; Body Mass Index ; Diabetes, Gestational/epidemiology* ; Female ; Gestational Weight Gain ; Glucose Tolerance Test ; Humans ; Pregnancy ; Pregnancy Outcome

Objectives To investigate the etiology, renal pathology, treatment, and prognosis of children's urinary system injury after hematopoietic stem cell transplantation (HSCT). Methods Clinical data of 81 children with urinary dysfunction after HSCT admitted to the Hematology Department in Children's Hospital of Soochow University were analyzed, and relevant literatures were reviewed. Results In 81 cases (50 males and 31 females), the age ranges from 8 months to 17 years old. Thirty cases (37%) with prerenal injury were recovered after active rehydration and other symptom specific treatment. There were 9 (11.1%) children with renal injury, four cases were given up therapy or transferred to other hospitals, thus lead to an unknown prognosis. Kidney biopsy was performed in the remaining five cases for pathological investigation. After active symptom-speific and etiology-based treatment, serum creatinine and glomerular filtration rate of four cases return to normal. But in the long-term follow-up,one case died of recurrence of primary disease, reinfusion of hematopoietic stem cell combined with renal failure. The remaining 3 patients were with chronic kidney disease (CKD). One case with renal thrombotic microangiopathy was in the chronic dialysis. Postrenal renal injuries were mainly hemorrhagic cystitis (28.4%) and urinary tract infection (16%). After a large dose of rehydration, urine alkalization and anti-infection therapy, they were recovered in the short term with a good prognosis. Conclusions Urinary injury after HSCT is mainly divided into three categories: prerenal, renal and postrenal, in which renal injury is prone to frequent recurrence.

Non-alcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver diseases ran ging from simple fatty liver(SFL) to non-alcoholic steatohepatitis(NASH),which in turn can evolve into cirrhosis and end stage of liver disease.With the improvement of living standards,the number of obese children gradually has increased,the detection rate of NAFLD also has showed an growing trend.However,the pathogenesis is still unclear.Auxiliary examinations include biochemical tests,imaging studies and liver biopsy,the last one is the "golden standard" of the diagnosis.The treatments of NAFLD consists of dietary intervention and lifestyle changes,even medical therapies.At present,the awareness of children NAFLD is imperfect,its diagnosis and treatment remain to be further exDlored.

Objective? To explore the effects of self-managed, home-based pulmonary rehabilitation on quality of life and motor ability in patients with chronic obstructive pulmonary disease (COPD) in rural areas. Methods? Totally 92 patients from rural areas diagnosed with COPD in inpatient or outpatient department of two county-level hospitals in Hubei province from October 2016 to November 2017 were selected using convenient sampling and divided into the experimental group (n=46) and the control group (n=46) according to the random number table. Patients in the control group received conventional diagnosis, treatment and nursing care, while patients in the experimental group received self-managed, home-based pulmonary rehabilitation for 13 weeks besides the conventional intervention. St. George's Respiratory Questionnaire (SGRQ) and Six Minutes Walking Test (6MWT) were used to evaluate and compare the quality and life and motor ability of the two groups before and after intervention. Results? A total of 74 COPD patients completed the study with 38 in the treatment group and 36 in the control group. There was no statistically significant difference in general information, SGRQ scores or 6 MWT between the two groups before intervention (P＞0.05); the SGRQ score of the treatment group was lower than that of the control group after intervention with statistical significance(P＜0.05). The 6 MWT of the treatment group was higher than that of the control group after intervention(P＜0.05). Conclusions? Self-managed, home-based pulmonary rehabilitation can improve the quality of life and motor ability of COPD patients in rural areas.