Objective To explore the predictive value of serum interleukin-17A(IL-17A),pentraxin-3(PTX3)and serum amyloid A(SAA)expression in Kawasaki disease(KD)children for non-response to in-travenous immunoglobulin(IVIG).Methods A total of 120 KD children who received IVIG treatment in the hospital from January 2022 to December 2024 were selected as the research objects.According to the response to IVIG treatment,they were divided into the sensitive group(n=90)and the non-response group(n=30).The clinical data of all children were collected.The predictive value of serum IL-17A,PTX3 and SAA expres-sion alone and in combination for non-response to IVIG treatment were explored by receiver operating charac-teristic(ROC)curve.The influencing factors of non-response to IVIG treatment in KD children were explored by multivariate Logistic regression.Results The levels of serum IL-17A,PTX3 and SAA in the non-response group were higher than those in the sensitive group(P＜0.05).The area under the curve(AUC)of serum IL-17A,PTX3 and SAA levels and their combined detection for predicting non-response to IVIG treatment were 0.704(95％CI:0.659-0.749),0.769(95％CI:0.719-0.819),0.813(95％CI:0.768-0.863),and 0.922(95％CI:0.877-0.967),respectively.The AUC of the combined detection of the three was larger than those of the individual detection of serum IL-17A,PTX3 and SAA(Zcombination-IL-17A=8.465,P＜0.001,Zcombination-PTX3=12.791,P＜0.001,Zcombination-SAA=9.984,P＜0.001).There were no statistically significant differences in age,body mass index(BMI),gender,KD type,fever duration before initial IVIG treatment,time from onset to ini-tial treatment,conjunctival congestion,changes in fingers and toes,rash,lymph node enlargement,platelet(PLT)count,hemoglobin(Hb)between the two groups(P＞0.05).The white blood cell(WBC)count,neu-trophil count(NEU),alanine aminotransferase(ALT),aspartate aminotransferase(AST)in the non-re-sponse group were higher than those in the sensitive group(P＜0.05).Multivariate Logistic regression analy-sis showed that serum IL-17A(OR=2.555,95％CI:1.529-4.270),serum PTX3(OR=3.473,95％CI:1.940-6.216),and serum SAA(OR=3.022,95％CI:1.823-5.011)were the risk factors of non-response to IVIG treatment(P＜0.05).Conclusion The combined detection of serum IL-17A,PTX3 and SAA levels can be used as important biological markers for predicting non-response to IVIG in KD children,providing a theoretical basis for early identification of high-risk children.

Objective To investigate the relation between lesions of medullary infarction and clinical symptoms and signs.Methods Eleven patients with medullary infarction confirmed by MRI were identified.Their clinical presentations and the relation between clinical presentation and location of lesion in MRI were assessed and analyzed.Results Among the 11 patients,5 cases suffered from lateral medullary infarction,6 medial medullary infarction(including two cases of bilateral infarction).Regarding clinical symptoms,common symptoms in lateral medullary infarction are blurred speech,dizziness,choking water,swallowing difficulties and facial numbness;in medial medullary infarction are limb weakness and blurred speech.The common signs of lateral medullary infarction are dysarthria,sensory disturbance,Horner sign and facial paralysis;in medial medullary infarction are paralysis of limbs and peripheral paralysis of the tongue.Conclusion Clinical manifestations are vailed depending on the sites of medullary infarction.MRI is helpful in diagnosing of medullary infarction.

Objective To investigate the possible role of abnormal signal transduction in smooth muscle cell in the pathogenesis of diabetic gastroparesis. Methods Healthy male SD rats were randomly divided into 2 groups: normal,model group,diabetes was induced by Ⅳ of alloxan,50mg/kg. Gastric emptying was measured by method of nutritious semisolid paste. The level of cAMP in gastric smooth muscle cell was measured by radioimmunoassay. Gsαand GiαmRNA positive cells were quantitatively measured by in situ hybridization and computer image analysis system respectively. Results ( 1 ) Gastric emptying rate of the normal was significantly higher than that of model group (P < 0.05 ) ; (2)the level of cAMP of the normal was significantly lower than that of model group( P < 0.05 ) ; (3)the expression of GsαmRNA in the model group was significantly higher than that of the normal groups( P < 0.05 ) ; (4) there was no marked difference in the expression of GiαmRNA between 2 groups( P > 0.05). Conclusion Altered expression of GSαmRNA may play a key role in the pathogenesis of diabetic gastroparesis.

Objective To study the effect of noninvasive pressure venrilation(NIPPV) on the treatment of acute exacerbarions of chronic obstructive pulmonary disease(COPD) with typeⅡrespiratory failure. Methods 46 cases of COPD were selected to treat with NIPPV in our hospital from 2001 January to 2005 May. The data in arterial blood gas(pH,PaO2,PaCO2),the course of disease in the hospital,the rate of endotracheal intubation, the mortality of the patients in NIPPV were analyzed and compared with those of the patients without NIPPV treatment before. Results The datas in arterial blood gas had been imprived significantly in NIPPV after 24h.The couse of disease in hospital was significantly shkrter,and the rate of endotracheal intubation and mortality of the patients was significantly lower in NIPPV than those in no NIPPV. There was remarkably difference between two groups. In NIPPV, the rate of endotracheal intubation were significantly lower in light and moderate trspiratkry failure than those in severe respiratory failure(P