Objective To explore the relationship between serum levels of anterior gradient 2(AGR2)and trimethylamine N-oxide(TMAO)and gut microbiota in children with inflammatory bowel disease(IBD).Methods A total of 145 IBD children were selected as the observation group,and children were divided into the ulcerative colitis group(64 cases)and the Crohn's disease group(81 cases)according to the disease type.Meanwhile,140 healthy children underwent physical examination in our hospital were included as the control group.Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay(ELISA).The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index(CDAI)score,and patients were divided into the active group(75 cases)and the remission group(70 cases)according to the disease activity.Fecal samples were collected for identification and count of intestinal flora.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease.The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test.Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD.Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group,and the serum TMAO level was higher than that in the control group(P＜0.05).The areas under the curve(AUC)of serum AGR2 and TMAO levels were 0.835,0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859,0.864 and 0.964 for diagnosis of Crohn's disease.The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group,and the serum TMAO level and numbers of Escherichia coli,enterococcus,Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group(P＜0.05).Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium,and negatively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium,and positively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD(P＜0.05).Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease,and it is more valuable in the diagnosis of Crohn's disease.Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Objective To explore the relationship between serum levels of anterior gradient 2(AGR2)and trimethylamine N-oxide(TMAO)and gut microbiota in children with inflammatory bowel disease(IBD).Methods A total of 145 IBD children were selected as the observation group,and children were divided into the ulcerative colitis group(64 cases)and the Crohn's disease group(81 cases)according to the disease type.Meanwhile,140 healthy children underwent physical examination in our hospital were included as the control group.Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay(ELISA).The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index(CDAI)score,and patients were divided into the active group(75 cases)and the remission group(70 cases)according to the disease activity.Fecal samples were collected for identification and count of intestinal flora.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease.The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test.Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD.Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group,and the serum TMAO level was higher than that in the control group(P＜0.05).The areas under the curve(AUC)of serum AGR2 and TMAO levels were 0.835,0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859,0.864 and 0.964 for diagnosis of Crohn's disease.The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group,and the serum TMAO level and numbers of Escherichia coli,enterococcus,Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group(P＜0.05).Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium,and negatively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium,and positively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD(P＜0.05).Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease,and it is more valuable in the diagnosis of Crohn's disease.Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Objective To investigate the clinical efficacy of budesonide combined with montelukast on treatment of children with cough variant asthma,and its influence on lung function and transforming growth factor-βl.Methods One hundred and seventeen children with cough variant asthma inXi'an Central Hospital from August 2013 to June 2016 were divided into control group and observation group.Fifty-nine children in control group were treated with aerosol budesonide,while 58 children in observation group were treated with montelukast based on control group.The lung function index including VC,FEV1,FEV1/FVC,and PEF pred％,TGF-β1,inflammatory factors including IgE,IL-8,TNF-α,and clinical symptom score in both groups were detected and analyzed before and after treatment.Results After two months of treatment,clinical symptom score in each group obviously decreased,and that in observation group was significantly lower than that of control group (P ＜ 0.05).The FEV1,FEV1/FVC,and PEF pred％ of two groups showed remarkable increase,and those in observation group were much higher than those of control group (P ＜ 0.05),while no conspicuous changes were detected in VC.Additionally,TGF-β1 of each group increased markedly,and that in observation group was much higher,while IgE,IL-8,and TNF-αin two groups showed obvious decrease,and those in observation group were significantly lower than those of control group (P ＜ 0.05).Conclusion Budesonide combined with montelukast had a great ability on treatment of children with cough variant asthma,and could significantly improve the lung function and levels of TGF-β1,and inhibit the levels of inflammatory factors.

Objective:To compare the clinical effect and safety of three different regimens treating children with severe pneumonia.Methods:120 cases treated in our hospital from January,2012 to January,2016 were randomly divided into the observation group 1 (dopamine combined with dobutamine,42 cases),observation group 2 (dopamine combined with phentolamine,40 cases),control group (38 cases).The clinical effect and levels of inflammatory cytokine were compared between the three groups.Results:The total effective rate in the observation group 1 was 90.48％ and that of observation group 2 was 87.5％,which were significantly higher than that of the control group (63.16％).The disappearance time of pulmonary rales,cough,dyspnea,pyretolysis and length of stay in the observation group (both 1,2) were significantly shorter than those of the control group (p ＜0.05).After therapy,the level of serum IL-6,IL-8,CRP and TNF-α in all the three groups were obviously decreased compared with those of before therapy (p＜0.05),and those of the observation group were significantly lower than the control group (p ＜ 0.05).Conclusion:Dopamine combined with dobutamine as well as dopamine combined with phentolamine were both effective methods in treating children with severe pneumonia,which were significantly better than conventional therapy.

Objective To compare the clinical effect and safety evaluation of three different dose regimens for treating children with viral encephalitis.Methods Totally 126 cases treated in Xi'an Central Hospital from January 2010 to December 2015 were randomly divided into observation group 1 (ganciclovir combined with gangliosides,42 cases),observation group 2 (ganciclovir combined with gamma globulin,43 cases),and control group (39 cases).The clinical effect and levels of NSE,inflammatory cytokine were compared in the three groups.Results The total effective rate in observation group 1 was 95.24％ and that of observation group 2 was 93.02％,which were significantly higher than that of control group (79.48％).The disappearance time of headache,fever,convulsions,clouding of consciousness,meningeal irritation sign,cerebrospinal fluid abnormalities,and length of stay in observation groups (both 1 and 2)were significantly shorter than those in control group (P ＜ 0.05);After therapy,the levels of NSE in three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and those in observation group were significantly lower than the control group (P ＜ 0.05);the levels of inflammatory cytokine in all three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and that of observation group 1 had no statistical difference with the normal group,whereas that in control group was significantly higher than the normal group (P ＜ 0.05).Conclusion Ganciclovir combined with gangliosides as well as ganciclovir combined with gamma globulin were both effective methods in treating children with viral encephalitis and could decrease levels of inflammatory cytokine.Ganciclovir combined with gangliosides could effectively repair nerve damage,which deserves clinical expansion.