Despite a more significant improvement in survival rates of premature and high-risk infants, surviving infants face a high risk of developing neurodevelopmental disorders such as cerebral palsy.Infant development is characterized by a dynamic continum, which makes it difficult to classify a child′s level of motor development as normal or abnormal on the basis of a single examination.This article provides a review of advances in the application of the predictive validity of General Movement Assessment (GMA) and the Alberta Infant Motor Scale (AIMS) in the early assessment and follow-up of infants and toddlers, in order to intervene in a timely manner with young children at potential motor risk.

AIM: To investigate the mechanism of baicalin-induced apoptosis in human laryngeal cancer cells. METHODS: AMC-HN-8 cells were selected for the study, and baicalin was applied to the cells at different concentrations (0, 10, 30, 100, and 300 μmol/L), and the half-inhibitory concentration (IC50) was measured by the CCK-8 method. Bax, cleaved-caspase-3, Cyto-c, IRF4 protein expression by protein blotting (Western blot); miR-125b-5p and IRF4 expression by RT-qPCR. Dual-luciferase reporter gene validation of Targetscan prediction (binding of miR-125b-5p to IRF4-3'UTR); apoptosis and necrosis inhibitors explore the way baicalein induces death in laryngeal cancer cells. AMC-HN-8 was then divided into blank group, baicalein (IC50), miR-125b-5p inhibitor group, baicalein + inhibitor NC group, baicalein+miR-125b-5p inhibitor group, and cell invasion and clone formation assays to detect cell invasion and proliferation ability, respectively. Apoptosis was detected by flow cytometry. RESULTS: Baicalein inhibited the proliferation of AMC-HN-8 cells in a dose-dependent manner with an IC50 value of 47.31 μmol/L. Compared with the blank group, 47.31 μmol/L baicalin induced apoptosis and inhibited cell invasion, while upregulating the expression of miR-125b-5p and suppressing the mRNA and protein levels of IRF4. The luciferase results showed that the miR-125b-5p mimic was able to inhibit the activity of the IRF4-3'UTR promoter relative to the NC mimic (mimic) group. Baicalein induces laryngeal cancer cell death in an apoptotic manner. In addition, the combination of 47.31 μmol/L baicalin and miR-125b-5p inhibitor affected the behavior of AMC-HN-8 cells, showing that compared with the blank group, the baicalin group showed a decrease in the number of cell clones, weakened invasion ability, and increased apoptosis; the miR - 125b-5p inhibitor group showed an increase in the number of cell clones, enhanced invasion ability and decreased apoptosis. The baicalin+ inhibitor NC group was consistent with baicalin, with no significant effect of inhibitor NC on cell behavior. The cloning, invasion, and apoptosis of cells in the baicalin+miR-125b-5p inhibitor group were intermediate between the baicalin and miR-125b-5p inhibitor groups. CONCLUSION: Baicalin inhibits the proliferation of AMC-HN-8 cells, and the mechanism may be related to miR-125b-5p targeting to inhibit the expression of IRF4, inducing the pro-apoptotic proteins Bax, cleaved-caspase3, and Cyto-c, and inhibiting the apoptosis suppressor protein Bcl-2 thereby inducing apoptosis.

Objective:To investigate the clinical characteristics and risk factors of bronchiolitis obliterans (BO) after adenovirus pneumonia.Methods:Clinical data of 266 children with adenovirus pneumonia hospitalized in Children′s Hospital of Soochow University from January 2011 to December 2017 were retrospectively analyzed.Accor-ding to whether they developed BO, children with adenovirus pneumonia were divided into the BO group and the non-BO group.Clinical features of the BO group and the non-BO group were compared by t test, rank sum test or chi square test.Risk factors were analyzed by Logistic regression approach. Results:Among 266 children with adenovirus pneumonia included, 37 patients were developed into BO group, and their age was significantly younger than that of the non-BO group [12.0(8.0, 17.5) months vs.32.0(13.0, 48.0) months, P<0.001]. Compared with the non-BO group, there were more proportion of preterm infants[10.8%(4/37 cases) vs.3.1%(7/229 cases), P=0.028], more instances of comorbidities [21.6%(8/37 cases) vs.4.4%(10/229), P<0.001] and more children with allergic diseas[35.1%(13/37 cases) vs.20.1%(46/229 cases), P=0.041] in the BO group, and the difference was statistically significant.The duration of fever in the BO group was significantly longer than that of the non-BO group [10(4.0, 13.5) d vs.6(4.0, 9.0) d, P=0.011] children with symptoms of wheezing, shortness of breath, and hypoxemia in the BO group were significantly more than the non-BO group[81.1%(30/37 cases) vs.27.9%(64/229 cases), P<0.001; 64.9%(24/37 cases) vs.5.7%(13/229 cases), P<0.001; 59.5%(22/37 cases) vs.6.6%(15/229 cases), P<0.001]. The platelet count, IgG level, and CD3 -CD 19+ lymphocyte percentage were significantly higher in the BO group than the non-BO group [(364±104)×10 9/L vs.(297±105)×10 9/L, P=0.001; 6.74(4.92, 10.16) g/L vs.5.93(1.00, 8.04) g/L, P=0.016; (33.5±15.3)% vs.(26.1±10.2)%, P=0.008]. In contrast, the percentage of CD3 + CD4 + lymphocytes in the BO group was lower than the non-BO group[(29.1±8.0)% vs.(32.5±9.4)%, P=0.044], the difference was statistically significant.The BO group had a higher rate of mixed bacterial infection than the non-BO groups[37.8%(14/37 cases) vs.16.6%(38/229 cases), P=0.003]. An age<26 months, comorbidities, premature birth history, wheezing, shortness of breath, and hypoxemia were independent risk factors for BO after adenovirus pneumonia( OR=4.808, 30.667, 7.558, 3.909, 8.842, 8.607, all P<0.05). Conclusions:An age of less than 26 months, a history of premature delivery comorbidities, wheezing, shortness of breath and hypoxemia, are independent risk factors for BO after adenovirus pneumonia.Children with above manifestations should receive high resolution CT as soon as possible to determine whether it is BO.

Objective To analyze the clinical characteristics and laboratory indexes of pneumonia complicated with pertussis syndrome in Suzhou area in order to provide the basis for rational treatment.Methods Children who had been hospitalized at Department of Respiratory,Children's Hospital of Soochow University during January 2012 to October 2016 were enrotled and diagnosed as pneumonia complicated with pertussis syndrome.A total of 236 cases were enrolled.Multiple pathogen detection and clinical information were collected in all patients.The subjects were divided into 28 days-＜ 3 months group,3-＜ 6 months old group,6-＜ 12 months old group and ≥ 12 months old group.The clinical data of children in each age group were retrospectively analyzed.Results Pneumonia complicated with pertussis syndrome was easy to occur within 6 months of infants,with the highest incidence in the 3-＜ 6 months group,there was a significant difference among the different age groups (x2 =231.870,P ＜ 0.05) [28 d-＜ 3 months group:5.3％ (102/1 910 cases),3-＜6 months group:5.7％ (76/1 341 cases),6-＜ 12 months group:2.0％ (36/1 762 cases),≥12 months group:0.4％ (22/5 304 cases)].The patients could become sick all the year round,with the highest incidence in summer[2.6％ (72/2 740 cases)in spring,3.7％ (96/2 611 cases)in summer,2.1％ (56/2 749 cases) in autumn,and 0.48％ (12/2 487 cases)in winter],and there were significant differences among the different seasons (x2 =62.380,P ＜0.001).Clinical symptoms were paroxysmal spasmodic cough,33.0％ (78/236 cases) of the performance with wheezing,mainly in the older than 3 months group.The incidence of fever was positively correlated with age(x2 =12.938,P ＜ 0.05).Peripheral white blood cell count and lymphocyte percentage increased,and the 3-＜ 6 months old group increased markedly.White blood cell count as high as (19.01 ± 11.99) × 109/L,the highest percentage of lymphocytes was up to 0.80,platelets were significantly increased in more than 80％ of children.The incidence of C-reactive protein (CRP) was negatively correlated with age,28 days-＜ 3 months group more prone to have high CRP.Pulmonary inflammatory pathology showed multiple pulmonary involvement by chest radiography,and it was more likely to occur in 28 d-＜ 3 months group.Viruses,bacteria and mycoplasma pneumoniae (MP) could cause pneumonia associated with pertussis syndrome,and mixed infection occurred in 56 cases.The top three pathogens were rhinovirus,MP and Streptococcus pneumoniae,and mixed infection was more prone to occur in 28 d-＜ 3 months group.Conclusion Pneumonia complicated with pertussis syndrome is easy to occur within 6 months of infants,with the highest incidence in summer.Viruses,bacteria and MP all could cause pneumonia associated with pertussis syndrome,and mixed infection could occur in some cases.The top three pathogens are rhinovirus,MP and Streptococcus pneumoniae.

Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.

Objective To investigate the whether miR‐125b expression having the abnormality in nasopharyngeal carcinoma tissues and serum and whether having the correlation with the sensitivity of cisplatin chemotherapy .Methods The intact medical records and tissue and serum samples in 34 cases of clinically diagnosed nasopharyngeal carcinoma were collected and the serum samples in 34 individuals undergoing the physical examination were also collected as the controls .The expression of miRNA‐125b in carcinoma tissue ,paracancerous tissue and serum was detected by real‐time quantitative polymerase chain reaction (real‐time qPCR) .The statistical analysis was performed .Results The expression of miRNA‐125b in carcinoma tissue was significantly lower than that in paracancerous tissue(P=0 .006) ,and serum miRNA‐125b expression in nasopharyngeal carcinoma patients was signifi‐cantly lower than that in the individuals undergoing the healthy physical examination(P=0 .000);but the miRNA‐125b expression had no correlation between the paracancerous tissue and serum(r=0 .112 ,P=0 .528) .The expression of miRNA‐125b in cancer tis‐sues was correlated with the pathological typing ,T staging and N staging(P<0 .05) ,the serum miRNA‐125b expression in carcino‐ma subjects was only related with the N staging (P<0 .05) .The expression of miRNA‐125b in carcinoma tissue was negatively cor‐related with the sensitivity of cisplatin chemotherapy (P< 0 .05) ,however ,there was no obvious correlation between the serum miRNA‐125b level and the sensitivity of cisplatin chemotherapy (P>0 .05) .Conclusion The low miRNA‐125b expression may be involved in the occurrence and development of nasopharyngeal carcinoma and plays a certain significance for the diagnosis ,pathology typing and classification of nasopharyngeal carcinoma .Its expression level in cancer tissue can serve as one of indicators for screen‐ing out the cisplatin chemotherapy sche.

Objective To study the causes, temporal courses, predictors and outcomes of delayed neurological deterioration (DND) after mild traumatic brain injury. Methods In a cohort of 254 patients, the incidence, causes and temporal courses of DND after mild traumatic brain injury were summed up. Univariate and multivariate (Logistic regression) analysis were performed to assess the predictors of DND. The short-term outcomes were compared between patients with and without DND. Results DND occurred in 14.2% (36/254) of the 254 patients. Intracranial causes of DND such as hematoma growth were observed in 91.7%(33/36) of patients with DND. The interval from arrival to DND was 0.5- 59.0 h. Thirty patients (83.3%, 30/36) deteriorated within 24 h. The univariate analysis revealed that dangerous injury mechanism, loss of consciousness, severe headache, more than 1 time vomiting, interval from injury to first CT scanning, first Glasgow coma scale (GCS) scores, basal skull fracture, hypocoagulability, heavy alcohol consumption were the predict factors for DND (P<0.05 or<0.01). The multivariate analysis revealed that interval from injury to first CT scanning (P=0.000, OR=0.169, 95% CI: 0.083- 0.344), first GCS scores (P = 0.004, OR = 0.355, 95%CI: 0.175- 0.721) and hypocoagulability (P=0.001, OR=0.077, 95%CI:0.017-0.354) were the independent predict factors for DND. All of the patients without DND recovered better. But in the patients with DND, 30 patients recovered better, 4 patients had slight disability, 1 patient had severe disability, and 1 patient died. The treatment outcome between two groups had significant difference (Z =-6.088, P = 0.000). Conclusions The causes of DND are mostly intracranial. Most patients deteriorat within 24 h. The interval from injury to first CT scanning, first GCS scores and hypocoagulability appear to be independent predictors of DND. DND is associated with poor short-term outcomes.

OBJECTIVE: To study the role of JNK (c-Jun N-terminal kinase) signal transduction pathway on the nasal mucosa remodeling in allergic rhinitis rats, to explore whether IL-1β participates the nasal mucosa remodeling in allergic rhinitis by JNK signal transduction pathway. METHOD: Totally 60 male Wistar rats (weighing about 200-250 g)were randomly divided into A (AR group) and B group (control group). The rats in A group were sensitized for inducing AR by intraperitoneal injection ovalbumin and Al(OH)₃. Ovalbumin was respectively dropped in each nasal cavity of every rat for 4,8,12 weeks(A4,A8,or A12 group) each had 10 rats. The rats in B group were sensitized by intraperitoneal injection saline. Saline was respectively dropped in each nasal cavity of every rat for 4,8, 12 weeks(B4, B8, or B12 group), and each had 10 rats. The concentration of IL-1β in serum and nasal lavage fluid were tested by ELASA. The protein expressions of P-JNK and P-c-Jun were detected by immunohistochemical technique. Linear correlation analysis showed the correlation between levels of IL-1β in serum and P-JNK protein, levels of IL-1β in nasal lavage fluid and P-JNK protein. RESULT: The concentrations of IL-1β in serum and nasal lavage fluid of A group were all significantly higher than those of the corresponding B group (all P < 0.01). Compared with A4 group and A8 group, concentrations of IL-1β in nasal lavage fluid of A12 group were significantly increased (all P < 0.01). However the levels of IL-1β in serum were not significantly different among them (all P > 0.05). Mean absorbance values of P-JNK and P-c-Jun in A group were significantly higher than those in corresponding B group (all P < 0.01) and compared with A4 group and A8 group, those of A12 group were significantly increased (all P < 0.01). Strong positive correlation were found between P-JNK and concentration of IL-1β in serum or nasal lavage fluid (r = 0.835 and r = 0.902, all P < 0.01). CONCLUSION JNK signal transduction pathway plays important role in the nasal mucosa remodeling in allergic rhinitis rats. IL-1β participates in AR nasal mucosa remodeling possibly partly through activating JNK signal transduction pathway.
Animals ; Disease Models, Animal ; Interleukin-1beta ; metabolism ; JNK Mitogen-Activated Protein Kinases ; metabolism ; MAP Kinase Signaling System ; Male ; Nasal Mucosa ; pathology ; Ovalbumin ; Paranasal Sinuses ; Rats ; Rats, Wistar ; Rhinitis, Allergic ; metabolism ; pathology ; Signal Transduction

OBJECTIVE: To study the role of P-JNK and P-c-Jun of JNK (c-Jun N-terminal kinase) on nasal mucosa remodeling in allergic rhinitis rats. METHOD: Sixty male Wistar rats (weighing about 200-250 g) were randomly divided into AR group (A group) and B group(control group). The rats in A group were sensitized for inducing AR by intraperitoneal injection of ovalbumin and Al(OH)₃. Rats in group A were randomized into A4, A8 and A12 group (each had 10 rats). Ovalbumin was dropped in each nasal cavity of every rat for 4,8,12 weeks, respectively. Rats in group B were sensitized by saline instead of OVA, and were also divided into B4, B8 and B12 group. Each group had 10 rats. Pathological changes of nasal mucosa in each period were observed by hematoxylin and eosin stain dyeing. The phosphorylation of JNK and c-Jun were tested by immunohistochemistry. RESULT: In A8 group, mucosal congestion and edema thickening with inflammatory cells infiltration of eosinophils were observed in the eighth week, and the inflammatory changes were significantly increased as time went on. The mean absorbance values of P-JNK and P-c-Jun in A group were significantly higher than those in the corresponding B group (all P < 0.01). Moreover, the mean absorbance values of A12 group were significantly higher than A4 group and A8 group (all P < 0.01 ). CONCLUSION The expression of P-JNK and P-c-Jun in the process of nasal mucosa remodeling in allergic rhinitis rats were increased, which suggested that P-JNK and P-c-Jun played important roles in nasal mucosa remodeling of the allergic rhinitis rats.
Airway Remodeling ; Animals ; Disease Models, Animal ; Eosinophils ; cytology ; Injections, Intraperitoneal ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Male ; Nasal Mucosa ; metabolism ; Ovalbumin ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Rhinitis, Allergic ; metabolism ; Signal Transduction

Objective To explore the relationship between the clinical features and the bacteria quantity confirmed by semi-quantitative culture of sputum in hospitalized infants with wheezing diseases.Methods Nine hundred and fifty-seven patients with wheezing diseases were enrolled from Jan.1,2010 to Dec.3 1,2011,and their clinical characteristics were collected.Respiratory seeretions were collected on admission by the pathogenic examination.They were grouped into 3 groups by the bacteria quantity,and the predictive analytics statistical saftware 20.0 was used to analyze the relationship between the clinical features and the bacteria quantity confirmed by semi-quantitative culture of sputum.Results 1.A total of 372(38.87％,372/957 cases)patients had positive sputum cuhures,and there were 585 patients in 0 + group,225 patients in 1 +-2 + group,147 patients in 3 +-4 + group;the main pathogens in 1 +-2 + group were haemophilus influenza (24.89％,56/225 cases) and streptococcus pneumonia (16.00％,36/225 cases) ;the main pathogens in 3 +-4 + group were streptococcus pneumonia(54.42％,80/147 cases) and haemophilus influenza(8.84％,13/147 cases).2.Presence of siblings,cyanosis,neutrophils and C-reactive protein were higher in 3 +-4 + group when compared with those of 0 + group,shortness of breath was common in 1 +-2 + group.3.Multinomial Logistic regression analysis identified the presence of siblings,residence,passive smoking,course of disease and cyanosis were identified as risk factors in 3 +-4 + group; gender,fever peak ＞ 38.5 ℃,breast-feeding,passive smoking,age,course of disease and cyanosis were as risk factors in 1 +-2 + group.4.Severe pneumonia was common in 3 +-4 + group.Conclusions Bacterial are often detected in infants hospitaled with wheezy episodes,and bacteria quantity is correlated with clinical presentation.Severe pneumonia is common in higher bacteria quantity group.