Objective To study the effects of combined telmisartan and ramiprll on heart function and renin - angiotensin - aldoste-tone system and ventricle remodeling and brain natriuretie peptide in patients with chronic heart failure (CHF). Methods 100 patientswith chronic heart failure were randomly divided into three groups: telmisartan group (A group, treated with telmisartan 80mg once daily, n =33), ramipril group (B group treated with ramipril 5mg once daily, n =33) and telmisartan plus ramipril group (treated with telmis-artan 40mg plus ramipril 2.5mg once daily, n = 34). Left ventricular end - diastolic dimensions (LVEDD) and left ventricular ejection fraction (LVEF) were assessed, and plasma renin activity (Ren) , angiotensinIl (Angll), aldosterone (Aid) and brain natriuretic pep-tide (BNP) were measured before and after therphy. Results After 6 months of treatment, LVEDD and LVEF were improved in all groups(P < 0.01). All changs were significant in C group than those in A group or B group(P < 0.01). The concentration of Ren were in-creased in all groups(P <0.01). The concentration of Angll was increased in A group and decreased in B group(P <0.01)while there was no difference at pre or post treatment in C group (P > 0.01). The concentration of Ald and BNP was decreased in all groups (P < 0.01). Ald and BNP were decreased more significantly in C group than those in A group or B group. Conclusion Combination of low dose of telmisartan and ramipril therapy has more benificial clinical features than telmisartan or ramipril alone in patients with CHF.

Biological agents has opened a new chapter in the targeted therapy of rheumatism,and provides a new choice for the rheumatism children who is refractory to traditional disease-modifying antirheumatic drugs.This article described the classification,application,efficency,side effects and precautions of the cytokines antagonists and the cell targeting biological agents,to provide a reference for rational application in clinical work.

Objective To investigate the changes and significance of platelet parameters and leucocyte in the children suffered from mycoplasma pneumoniae pneumonia (MPP).Methods The platelet parameters (PLT),the platelet volume(MPV),the platelet distribution width (PDW),and the white blood cell count(WBC) were detected by automatic blood cell analyzer respectively in 300 children with MPP before and after the treatment by macrolides antibiotics for a week as well as in 40 normal children.The comparison was made among them.Results There were 156 cases that suffered from thrombocytosis (PLT ＞ 300 × 109/L) in MPP group,the incidence rate was 52.0％(156/300).While there was 1 case with thrombocytopenia,the incidence rate was 0.3％ (1/300).The WBC,MPV and PDW in MPP group before and after one-week treatment were higher than the control group.And the PLT was higher than the initial stage of hospitalization and the control group.The differences had statistical significance.Conclusion The incidence rate of thrombocytosis was high in the children suffered from MPP.The dynamic observation of platelet parameters and WBC in children with MPP could be used as the elementary basis of judging MP infection.

Objective To study the effect of IFN-αcombined with ATRA in liver cancer therapy in perioperative phase of inter-vention .Methods An animal model of liver cancer CBRH7919 was established by implanting 28 Wistar rats with tumor tissue .The hepatic artery was tied off in one month after formation of tumor .All the rats were randomly divided into the experimental group (14 cases) and the control group(14 cases) .The control group accepted peritoneal injection with normal saline while the experimen-tal group accepted IFN-αcombined with ATRA .10 days later ,all the rats were sacrificed .And the level of expression of VEGF ,bF-GF ,mirovessel density ,and apoptotic index of tumor cells were measured .Results Serum VEGF level ,MVD and apoptotic index of tumor cells of the experimental group were statistically lower than that of the control group [(91 .8 ± 12 .7) pg/mL ,(115 .7 ± 11 .8)/HP ,(12 .29 ± 4 .53)% vs .(67 .4 ± 18 .3)pg/mL ,(65 .3 ± 7 .2)/HP ,(3 .81 ± 1 .52)% ,t=4 .099、13 .642、6 .640 ,P<0 .05)] , results of RT-PCR and immunohistochemistry detection both showed that the levels of expression of VEGF and bFGF of the exper-imental group was lower than that of the control group .Conclusion IFN-αcombined with ATRA in liver cancer therapy in periop-erative phase of intervention could suppress the generation of neoplastic vascular and improve the effect of the intervention .So it is worth promoting .

With the development of modem technology,more and more plastic products are widely used in various fields,while bringing significant convenience to the society,it also leads to more and more environmental estrogen.The influence of plasticizer is increasing,especially on the development of children.Extensive contacting with plasticizer is considered to be closely related with gonadal digenesis,obesity and other problems in children.This review focuses on the latest research results about the basic and clinical experiments of Di (2-ethylhexyl) phthalate (DEHP),which illuminate the effects of DEHP on children's growth and metabolism,and lay foundations for rational clinical intervention and scientific plasticizer's application.

Objective To investigate the changes of the anion gap(AG)in the premature suffered from hyperbilirubinemia,to provide the basis for treatment.Methods The serum electrolyte,the renal function and the liver function in 94 premature babies suffered from hyperbilirubinemia were tested,and then calculated the value of AG,while the arterial blood gas analyses were done in 36 cases.Results 44 cases had high AG(46.81％),44 cases had normal AG(46.81％)and 6 cases had low AG(6.38％).The increase of AG was directly proportional to the concentration of Na+in blood,while was inversely proportion to the concentration of HCO3-.There was no close relationship between the AG and BUN,Scr in the serum.Conclusion The incidence rate of metabolic acidosis poisoning was high in premature suffered from hyperbilirubinemia with high AG,so the routine test of blood electrolyte,renal function and arterial blood gas should be done.Calculate the value of AG to guide the treatment,and to avoid correcting the acid by the alkali blindly.

Objective To assess the value of spiral and cine CT for the diagnosis of foreign body in trachea in children. Methods Fifty-one consecutive pediatric patients suspected of aspirating radiolucent foreign body underwent chest radiography, 12 of them underwent three-dimensional spiral CT and cine CT scan within 24 h before rigid bronchoscopy. Results Rigid bronchoscopy showed foreign bodies in the main bronchus or bronchus intermedius of 42 patients, while spiral CT localized airway foreign bodies in the same patients. In the remaining 9 patients without foreign body found by rigid bronchoscopy, 6 were true-negative and 3 were false-positive on CT, making the overall sensitivity, specificity, accuracy, and positive and negative predictive values of CT scans was 100% (95% confidence interval, 91%-100%), 66.67% (29%-92%), 94.12% (64%-99%), 93.33% (81%-98%) and 100% (54%-100%), respectively. The cine CT scan correctly diagnosed 9 of 12 patients as true-positive and 3 as true-negative with identification of air trapping and secondary lung changes. Conclusion CT may be used in airway foreign body management of pediatric patients, especially with diagnostic dilemmas, and further prospective evaluations should be considered to assess its overall efficacy.

BACKGROUND:Studies have shown that methylation modification using CARM1-catalyzed histone H3R17/R26 can maintain the stemness of embryonic stem cel s. However, mechanism underlying CARM1 effect on the stemness of amniotic fluid-derived stem cel s is stil unclear.
OBJECTIVE:To investigate the function and underlying molecular mechanism of CARM1 to maintain stemness in the amniotic fluid-derived stem cel s.
METHODS:Amniotic fluid-derived stem cel s from term pregnancy were isolated and cultured. RT-PCR was used to identify the stem cel mark and CARM1 gene expression. CARM1 expression in amniotic fluid-derived stem cel s was knocked down by using two shRNA. RT-qPCR was used to detect the silencing efficiency, and western blot employed to examine the methylation level of Arginines 17 at N terminus of histone 3 (H3mR17). Moreover, the expression of embryonic stem cel markers, including OCT4, SOX2 and NANOG, were detected.
RESULTS AND CONCLUSION:Amniotic fluid-derived stem cel s from term pregnancy could express CARM1 and stem cel markers, including OCT4, SOX2, Nanog and KLF4. Both of the shRNAs could knock down the expression of CARM1 efficiently. When CARM1 was knocked down, the H3mR17 level was decreased and OCT4, SOX2 expression was also reduced, but NANOG expression had no change. Al these indicate that CARM1 is required for amniotic fluid-derived stem cel s to maintain stemness through regulating OCT4 and SOX2 expression.

Respiratory distress syndrome( RDS) is a critical respiratory disease and commonly occurs in preterm infants. Preterm RDS is mainly due to the deficiency of lung surfactant. However,recent studies have in-dicated that genetic susceptibility may involve in the pathogenesis of RDS in preterm infants. In this paper,recent research progresses of genetic susceptibility and related candidate genes of RDS in preterm infants at home and abroad are reviewed.

Objective To determine the role of SCN1A gene variation in the development of familial febrile seizures (FS).Methods Clinical data were collected from 8 familial FS pedigrees, and peripheral venous blood samples were collected from the probands and other available family members. All 26 coding exons and exon-intron boundaries at least 50 bases of the human SCN1A gene were amplifled by polymerase chain reaction, the products were subsequently sequenced. To novo variation, other family members were screened for the corresponding exons. Two hundred age-matched healthy children were served as normal controls. ResultsA total of 33 variations in the SCN1A gene were identifled in these families. Of these variations, one was a missense mutation; the remaining 32 variations were previously submitted as single nucleotide polymorphisms (SNPs). A c.2650G>A heterozygous missense mutation in exon 15 of the SCN1A gene found in the proband of family 4 was inherited from his father who had seizures with fever in early childhood. The c.2650G>A mutation was absent in the 400 alleles of normal controls. To the best of our knowledge, the SCN1A c.2650G>A mutation has neither been reported in the NCBI SNP database nor in the literature to date. The c.2650G>A mutation changes a glycine at amino acid 884 in the SCN1A protein to a serine (p.Gly884Ser). Protein sequence analysis showed that the p.Gly884Ser is located at a highly conserved region between the 4th and 5th transmembrane segment of the homologous domain Ⅱ of voltage-gated sodium channel 1 subunit (DIIS4-S5). ConclusionsThe pathogenesis of familial febrile seizures was related to the SCN1A variation, the mutation outside the region of the voltage sensor (S4) and ion channel pore (S5-S6) of the voltage gated sodium channelα-subunit may be an important factor to cause mild phenotype epilepsy syndrome.