Food allergy(FA) seems to be increasing world wide which is roughly divided into IgE mediated or non-IgE mediated FA(NFA).NFA primarily affects the gastrointestinal mucosa which is far less understanding the immunological mechanisms than IgE-mediated FA.Clinicians sometimes experienced confusion due to delayed onset of symptoms and subsequent difficulty in making the clinical association between offending food and clinical symptoms.The lack of easily accessible diagnostic measures also contributes to the problem.The diagnosis of NFA usually is established in the eliminated of food allergen and food challenge test.In this paper,the diagnosis and treatment of NFA is introduced combined with our clinical practice experience.

Meckel′s diverticulum is the most common congenital anomaly of the gastrointestinal tract. Most ca-ses are asymptomatic,while it can be symptomatic when complications happened,its complications often expressed as hematochezia,abdominal pain,vomit,fever,and so on. When signs or symptoms arise from a Meckel′s diverticulum, morbidity and mortality will increase. So make a definite diagnosis of the diverticulum play an important role in the treatment of Meckel′s diverticulum. In this essay,now illustrate the meaning of imaging examination about the diagnosis of Meckel′s diverticulum,wish to make a diagnosis as soon as possible.

Objective To analyze the main clinical manifestations,laboratory features and prognosis of neonatal intrahepatic cholestasis caused by Citrin defiency (NICCD).Methods Twenty-nine NICCD infants were diagnosed by blood tandem mass spectrometry (MS-MS)analysis and/or SLC25A13 mutation analysis from July 2012 to February 2015 in Children's Hospital of Chongqing Medical University.Clinical data of 29 cases were analyzed retrospectively which included manifestations,laboratory features and prognosis.The general situation,feeding,liver function,growth were followed up.Results Twenty-nine infants suffering from NICCD presented jaundice in an early time,and some clinical manifestations were investigated such as hepatomegaly (20/29 cases),splenomegaly (3/29 cases),anemia (14/29 cases),and failure to thrive (9/29 cases).Laboratory data suggested that all of 29 patients had increased conjugated bilirubin,total bile acid,γ-glutamyl transferase and alkaline phosphatase.Some patients also showed abnormal coagulation function (20/22 cases),dyslipidemia (9/20 cases),increased blood lactic acid (22/26 cases) and alpha-fetoprotein (14/14 cases),decreased albumin (24/29 cases),blood glucose (17/22 cases) and ceruloplasmin (4/4 cases).The pathological analysis of one patient's liver indicated the edema and degeneration of liver cells,intrahepatic cholestasis and a small amount of fibrous tissue hyperplasia in portal area.MS-MS analysis of blood samples revealed distinctive increase in methionine,tyrosine,threonine,citrulline,arginine and free carnitine,long chain acyl-carnitine in most patients.Gas chromatography-mass spectrometer (GC-MS) analysis of urine samples mainly showed elevated 4-hydroxyphenyllactic acid and 4-hydroxyphenylpyruvic acid.Prognosis showed that most of the NICCD patients (8/29 cases) could recover in one-year old with a lactose-free,medium chain triglyceride-enriched formula,and one patient died of liver cirrhosis.Three patients at over one-year old had the preference of a high protein and low carbohydrate diet.Conclusions Infants might be considered to have NICCD if they have jaundice in an early time,with the clinical characteristics of hepatomegaly,splenomegaly,abnormal coagulation function,anemia,failure to thrive,dyslipidemia,decresed albumin and blood glucose,increased blood lactic acid and alpha-fetoprotein.After that further tests of MS-MS,GC-MS and gene analysis of this disease are needed to confirm diagnosis.

Food allergy is a common illness in children,which is divided into IgE-mediated,non-IgE mediated and mixed-mediated food allergy.Gastrointestinal tract is the mainly affected organ,mostly mediated by non-IgE mechanism.Gastrointestinal food allergy are lack of unified diagnostic criteria currently,whose mechanism is also elusive.Moreover,the double-blind placebo-controlled food challenge is the gold standard for the diagnosis of food allergy.This review focuses on the procedure for the oral food challenge and its application in the diagnosis of gastrointestinal food allergy.

Drug induced liver injury(DILI) is one of the most common factors causing liver damage and liver failure in children.And in most cases,patients' manifestations lack characteristic features.Thus,patients will develop gastrointestinal symptoms such as jaundice,nausea,vomiting and abdominal abstention until serious hepatic dysfunction.Futhermore,some patients are likely to develop acute liver failure,even death,without drug discontinuation and timely intervening measures.Early diagnosis and effective therapies considerably make sense.This review aims to illustrate the mechanism,manifestations,diagnosis and treatment of DILI in children,in order to promote the early treatment of the disease,reduce the serious complications and improve survival rate in clinical work.

Chronic intestinal pseudo-obstruction(CIPO)is an intestinal motility dysfunction caused by intestinal myopathies or neuropathies or mesenchymopathies.The clinical manifestation is almost the same with mechanical intestinal obstruction,but in the absence of any obstruction in the gastrointestinal tract.According to etiology,it can be divided into primary and secondary.While according to gastrointestinal neuromuscular disorders,it can be categorized as myopathy,neuropathy and mesenchymopathy,which have different pathogenesis.The disease with the clinical manifestation,imaging examination or histopathology was diagnosed,but mechanical intestinal obstruction must be excluded.Presently,the therapies of CIPO mainly are stimulating the motility of intestine and ensuring the necessary nutrition of the children.The review is mainly focused on the research progress of the pathogenesis,clinical manifestation,diagnosis,therapy of pediatric CIPO in recent years.

Objective]To investigate the effect of acupuncture-assisted anesthesia on cerebral state index(CSI) under the steady-state anesthesia of sevoflurane. [Methods] Fifty patients scheduled for elective knee arthroscopy operation were randomly divided into two groups with 25 in each. All patients were induced with sevoflurane, the end-tidal concentrations of sevoflurane in two groups were adjusted to 1.0 MAC and maintained for 15 min after tracheal intubation, acupuncture-assisted anesthesia was used on the affected side in group A, Yanglingquan(GB34) and Zusanli(ST36) were selected as the acupoints. The positive and negative electrodes of the electropuncture apparatus(G8650) were respectively connected with Yanglingquan(GB34) and Zusanli(ST36). People reccived transcutaneous electrical acupoint stimulation with condensation-rarefaction wave(2/15 Hz, 8~12mA) untill the end of operation, patiant's body types SBP, SDP, MAP, HR and CSI were recorded at lying still for 5 min(T1), steady state of sevoflurane(T2), acupuncture-assisted anesthesia after 20 and 30 min(T3, T4). [Results] SBP, DBP, MBP, HR and CSI at T3~T4 were significantly lower in group A than those in group B and T2(P<0.05). [Conclusion]Acupuncture-assisted anesthesia can reduce the CSI under the steady-state anesthesia of sevoflurane and lower blood pressure and heart rate at the same time.

OBJECTIVE:To study the bioequiavailability of both the domestic and the imported azithromycin tablets in healthy human body.METHODS:The serum concentrations in 12 healthy volunteers was determined by HPLC-UV after administration of a single oral dose of 500mg azithromycin tablets by a cross-over design.The compartment model was discriminated by F-test and AIC method and the pharmacokinetic parameters were calculated by DAS program.RESULTS:The optimal compartment model fitted to two-compartment model.The main pharmacokinetics parameters of the domestic azithromycin tablets vs.the imported ones were the following:Cmax was(437.4 670? 51.5 670),(442.9 670? 61.5 030)? g/L;t1/2? was(44.7 450? 13.1 750),(49.2 670? 15.1 740)h;tmax was(2.5 830? 0.5 150),(2.5 830? 0.5 150)h;AUC0～ 144 was(13.2 799? 2.9 827),(12.1 953? 2.9 140)(mg? h)/L.The relative bioavailability of the domestic azithromycin tablets was(101.7? 0.1)%.CONCLUSION:The domestic azithromycin tablets and the imported ones were bioequivalent.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, and is also a common cause of recurrent abdominal pain in children.The pathogenesis of IBS has not been completely clarified, and it is currently believed to be related to factors such as gastrointestinal dysmotility, visceral hypersensitivity, and brain-gut axis dysfunction.Pediatric IBS often shows abdominal pain, bloating, accompanied by altered bowel habits, while its clinical manifestations are not specific.The diagnosis of IBS is usually made based on the Rome Ⅳ criteria.The ultimate goal of treatment is to improve the quality of life of children, including alleviating the abdominal pain of children and restoring normal bowel habits.The treatment mainly includes adjusting diet and lifestyle, medicine etc.This review is to investigate the progress of the pathogenesis, diagnosis and treatment of IBS in recent years.

BACKGROUND: The rudiment of tissue engineering is to obtain tissue from patients. The cells are expanded into a population through cellular culture, and seeded into scaffolds, which can accommodate and guide the growth and proliferation of new cells in the three-dimensional scaffolds. At last, the constructed tissue is transplanted in vivo to repair or replace damaged or diseased tissues. Afterward neovascularization of the graft, the scaffolds are absorbed gradually. Finally, the new tissue replaces completely the damaged or diseased tissuesOBJECTIVE: To evaluate the feasibility of designing and fabricating customized anatomical-shaped bone tissue-engineering scaffolds with reverse engineering and rapid prototyping (RP) techniques. To avoid the disadvantage of the conventional fabricated methods of the scaffolds.DESIGN: The method of fabricating customized anatomical-shaped bone tissue engineering scaffolds.SETTING: Computer-aided design (CAD) of the scaffold was conducted in CAD training center, Guangdong Machinery Research Institute. Rapid prototyping fabrication of the scaffold was conducted in Guangdong Longchuangyu Limited Cooperation. The scaffold was fabricated by sterophotocureable technology and was made of photosensitized resin.METHODS: This experiment was carried out at the Center of Department of Traumatic Orthopedics, General Hospital of Guangzhou Military Area Command of Chinese PLA from October 2004 and January 2005. According to reverse engineering, layered image information of skeleton of the patients was scanned with CT/MRI. Anatomical models of region of interesting were created by means of CT or MRI three-dimensional reconstruction and surface reconstruction. The internal construction of the scaffolds was designed with CAD software in the outline of the anatomical models to develop computer-aided model. The prototypes of the scaffolds were fabricated by RP process.MAIN OUTCOME MEASURES: ①CT/MRI scanning, three-dimensional reconstruction, anatomical modeling; ② computer-aided design of customized bone tissue engineering scaffolds; ③rapid prototyping fabrication of customized bone tissue engineering scaffold.RESULTS: ①Anatomical models of bone joint were established through CT/MRI three-dimensional reconstruction. ② The internal structure of the scaffold was designed to establish the entity model of bone tissue engineering scaffold successfully with computer-aided design software. ③ CAD model of bone tissue engineering scaffold guided prototypes to develop the customized anatomical-shaped bone tissue engineering scaffolds. The internal structure of bone tissue engineering scaffold was fine and had high degree of porosity-and pore interconnectivity.CONCLUSION: Customized anatomical-shaped bone tissue engineering scaffolds can be fabricated with reverse engineering and RP technology. Among all RP processes, stereophotocureable technology (SLA) is the best one with good precision, smooth surface and good shaping.