Abstract:Objective To study the changes of nitric oxide (NO) and endothelin-1 (ET-1) and the relationship between these changes and this prognosis in newborns with pulmonary hemorrhage (PH). Methods Nitric acid reductase and radioimmunoassay methods were respectively used to measure concentrations of serum NO and plasma ET-1 in group control (n=15), group survival with PH within an acute phase (survival, n=13), group survival with PH within a recovery phase (recovery, n=13) and group deadth with PH (deadth, n=7). Results The concentrations of serum NO were 63.0±10.7 μmol/L, 32.0±7.5 μmol/L, 68.2±6.9μmol/L and 20.1±5.2 μmol/L in group control, group survival, group recovery and group death respectively. The concentrations of ET-1 were 19.6 ± 4.0 ng/L, 43.0 ± 8.9 ng/L, 20.7 ± 4.5 ng/L and 54.1±3.9 ng/L respectively. The rates of NO/ET-1 were 3.21, 0.74, 3.29 and 0.37 respectively. The differences among the four groups were markedly significant.Conclusions The concentration of NO is decreased, while the concentration of ET-1 is elevated in newborns with PH.The rate of NO/ET-1 is strongly correlated with the severity of illness and may be considered as an indicator of the prognosis of PH.

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Objective To study the changes of nitric oxide (NO) and endothelin-1 (ET-1) and the relationship between these changes and this prognosis in newborns with pulmonary hemorrhage (PH). Methods Nitric acid reductase and radioimmunoassay methods were respectively used to measure concentrations of serum NO and plasma ET-1 in group control (n=15), group survival with PH within an acute phase (survival, n=13), group survival with PH within a recovery phase (recovery, n=13) and group deadth with PH (deadth, n=7). Results The concentrations of serum NO were 63.0±10.7 μmol/L, 32.0±7.5 μmol/L, 68.2±6.9μmol/L and 20.1±5.2 μmol/L in group control, group survival, group recovery and group death respectively. The concentrations of ET-1 were 19.6 ± 4.0 ng/L, 43.0 ± 8.9 ng/L, 20.7 ± 4.5 ng/L and 54.1±3.9 ng/L respectively. The rates of NO/ET-1 were 3.21, 0.74, 3.29 and 0.37 respectively. The differences among the four groups were markedly significant.Conclusions The concentration of NO is decreased, while the concentration of ET-1 is elevated in newborns with PH.The rate of NO/ET-1 is strongly correlated with the severity of illness and may be considered as an indicator of the prognosis of PH.

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Objective To study the change and the clinical significance of neopterin in patients with rheumatic fever. Methods The concentrations of serum neopterin in patients with acute rheumatic fever(ARF), chronic inactive rheumatic heart disease(CRHD) and healthy controls were measured by ELISA method. Results The concentrations of serum neopterin in patients with ARF(7.84±6.31 nmol/L) were significantly higher than those in patients with CRHD (4.31±2.59 nmol/L, P<0.05) and healthy controls (2.91±2.26 nmol/L,P<0.01); the concentrations of serum neopterin in patients with CRHD were almost the same with those in the healthy controls (P>0.05). Conclusions The concentrations of serum neopterin increased in ARF, while decreased in CRHD. The serum neopterin levels can reflect the activity of the disease. Neopterin may be used as a marker to detect T cells activated by ARF.

Abstract:Objective To study the change and the clinical significance of neopterin in patients with rheumatic fever. Methods The concentrations of serum neopterin in patients with acute rheumatic fever(ARF), chronic inactive rheumatic heart disease(CRHD) and healthy controls were measured by ELISA method. Results The concentrations of serum neopterin in patients with ARF(7.84±6.31 nmol/L) were significantly higher than those in patients with CRHD (4.31±2.59 nmol/L, P<0.05) and healthy controls (2.91±2.26 nmol/L,P<0.01); the concentrations of serum neopterin in patients with CRHD were almost the same with those in the healthy controls (P>0.05). Conclusions The concentrations of serum neopterin increased in ARF, while decreased in CRHD. The serum neopterin levels can reflect the activity of the disease. Neopterin may be used as a marker to detect T cells activated by ARF.

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Objective To understand the shift of apoptosis in lymphocyte of children with myocarditis, to investigate the pathogenesis of myocarditis.Methods To detect the shift of apoptosis in T-lymphocyte by immunofluorescence among 41 children with myocarditis including infection of virus and mycoplasma, and the alteration of T-lymphocytic subgroup and immunoglobulin at the same time. Results The apoptosis of lymphocytes in myocarditis group was higher than that of normal group, and T-lymphocytic subgroup CD 4 +, CD 4 +/CD 8 + were distinctly descented, CD 8 + was elevated(P<0.01). Conclusions The excessive apoptosis of lymphocytes lead imbalance of the amount. The low functions of T-lymphocyte and humour immunity are one of the important cause of the myocarditis induced by the infection of virus or mycoplasma.

Abstract:Objective To understand the shift of apoptosis in lymphocyte of children with myocarditis, to investigate the pathogenesis of myocarditis.Methods To detect the shift of apoptosis in T-lymphocyte by immunofluorescence among 41 children with myocarditis including infection of virus and mycoplasma, and the alteration of T-lymphocytic subgroup and immunoglobulin at the same time. Results The apoptosis of lymphocytes in myocarditis group was higher than that of normal group, and T-lymphocytic subgroup CD 4 +, CD 4 +/CD 8 + were distinctly descented, CD 8 + was elevated(P<0.01). Conclusions The excessive apoptosis of lymphocytes lead imbalance of the amount. The low functions of T-lymphocyte and humour immunity are one of the important cause of the myocarditis induced by the infection of virus or mycoplasma.

Abstract:Objective To determine sputum ECP, IL-5, sIL-2R and IgE levels in children with asthma in different stages and investigate their correlation and clinical significance.Methods The sputa were obtained from children with asthma and normal control children.The concentration of ECP was assayed with pharmacia CAP system; IL-5, sIL-2R and IgE levels were measured with double-antibody ELISA technique. Results Levels of ECP, IL-5,sIL-2R and IgE in sputum during acute attack stage were significantly higher than those in remission stage and group normal control.The level of IL-5 in sputum positively correlated with that of sIL-2R and ECP respectively. The level of sIL-2R in sputum positively correlated with that of ECP and IgE respectively.Conclusions This findings suggest that all of four indices are involved in formation of airway inflammation. Their concentrations in sputum are sensitive to reflect changes of airway inflammation, and serves as safe and practical indices of monitoring the severity of disease and conducting anti-inflammation treatment,especially, ECP and sIL-2R are more sensitive.

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Objective To determine sputum ECP, IL-5, sIL-2R and IgE levels in children with asthma in different stages and investigate their correlation and clinical significance.Methods The sputa were obtained from children with asthma and normal control children.The concentration of ECP was assayed with pharmacia CAP system; IL-5, sIL-2R and IgE levels were measured with double-antibody ELISA technique. Results Levels of ECP, IL-5,sIL-2R and IgE in sputum during acute attack stage were significantly higher than those in remission stage and group normal control.The level of IL-5 in sputum positively correlated with that of sIL-2R and ECP respectively. The level of sIL-2R in sputum positively correlated with that of ECP and IgE respectively.Conclusions This findings suggest that all of four indices are involved in formation of airway inflammation. Their concentrations in sputum are sensitive to reflect changes of airway inflammation, and serves as safe and practical indices of monitoring the severity of disease and conducting anti-inflammation treatment,especially, ECP and sIL-2R are more sensitive.

Abstract:Objective To study the effect of severe obesity on blood viscosity. Methods Blood viscosity and its major determinants were checked in 27 children with severe obesity and in 20 normal children. Results Plasma and whole blood viscosity were significantly increased in the obese group. The increase in low shear blood viscosity and aggregation index of RBC suggested an increased erythrocyte aggregation which can be explained mainly in terms of the effects of increased fibrinogen concentration and plasma viscosity, and the increase in high shear blood viscosity and TK (Deformability Index of RBC) indicated a decreased erythrocyte deformability which was associated with the levels of fibrinogen, cholesterol and plasma viscosity. Conclusions Severe obesity can cause blood hypercoagulation leading to a risk factor of cardiovascular and cerebrovascular diseases.

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Objective To study the effect of severe obesity on blood viscosity. Methods Blood viscosity and its major determinants were checked in 27 children with severe obesity and in 20 normal children. Results Plasma and whole blood viscosity were significantly increased in the obese group. The increase in low shear blood viscosity and aggregation index of RBC suggested an increased erythrocyte aggregation which can be explained mainly in terms of the effects of increased fibrinogen concentration and plasma viscosity, and the increase in high shear blood viscosity and TK (Deformability Index of RBC) indicated a decreased erythrocyte deformability which was associated with the levels of fibrinogen, cholesterol and plasma viscosity. Conclusions Severe obesity can cause blood hypercoagulation leading to a risk factor of cardiovascular and cerebrovascular diseases.

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Abstract:Objective To examine the role of echocardiography in diagnosing and following-up the coronary arterial lesion in Kawasaki disease.Methods 259 cases of Kawasaki disease were detected by echocardiography. 97 cases of them were followed-up.Results Among them 48 cases were found to have coronary arterial lesions(18.5%), 90% presented evidence of coronary arterial lesion in the first-three-week illness. The lesion of LCA occured more common than RCA. The followed-up result reveals an easier recovery of mild dilatation farmation. 2 cases of coronary arterial aneurysm remain persistent.The inside diameter of arterial aneurysm was an important agent of prognosis.Conclusions Echocardiography is the most useful noninvasive technique to detect coronary arterial lesion.

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Objective To examine the role of echocardiography in diagnosing and following-up the coronary arterial lesion in Kawasaki disease.Methods 259 cases of Kawasaki disease were detected by echocardiography. 97 cases of them were followed-up.Results Among them 48 cases were found to have coronary arterial lesions(18.5%), 90% presented evidence of coronary arterial lesion in the first-three-week illness. The lesion of LCA occured more common than RCA. The followed-up result reveals an easier recovery of mild dilatation farmation. 2 cases of coronary arterial aneurysm remain persistent.The inside diameter of arterial aneurysm was an important agent of prognosis.Conclusions Echocardiography is the most useful noninvasive technique to detect coronary arterial lesion.

Abstract:Objective To guide the clinical use of anthracycline in childhood leukemia and lymphoma patients, and to lessen the anthracycline-induced cardiac impairment.Methods Echocardiography, electrocardiography, myocardio-enzymes and chest X-ray were used to evaluate the cardiac function before and after chemotherapy. Results In 85 cases the total abnormal rate of echocardiogram was 38.82% (33/85), 20.93% (9/43) prechemotherapy and 50% (21/42) post-chemotherapy. The abnormal rate increased apparently in patients whose anthracycline cumulative dosage was ≥350 mg/M 2 . Two patients died of cardiomyopathy,whose cumulative dosages were 100 mg/M 2 and 454.35 mg/M 2 respectively . Conclusions It is recommended to monitor cardiac function in childhood leukemia and lymphoma during chemotherapy period. The dose of anthracycline should be modified according to the cardiac function and the cumulative dosage. It is sensitive and practicable for echocardiography to monitoring cardiac function.

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Objective To guide the clinical use of anthracycline in childhood leukemia and lymphoma patients, and to lessen the anthracycline-induced cardiac impairment.Methods Echocardiography, electrocardiography, myocardio-enzymes and chest X-ray were used to evaluate the cardiac function before and after chemotherapy. Results In 85 cases the total abnormal rate of echocardiogram was 38.82% (33/85), 20.93% (9/43) prechemotherapy and 50% (21/42) post-chemotherapy. The abnormal rate increased apparently in patients whose anthracycline cumulative dosage was ≥350 mg/M 2 . Two patients died of cardiomyopathy,whose cumulative dosages were 100 mg/M 2 and 454.35 mg/M 2 respectively . Conclusions It is recommended to monitor cardiac function in childhood leukemia and lymphoma during chemotherapy period. The dose of anthracycline should be modified according to the cardiac function and the cumulative dosage. It is sensitive and practicable for echocardiography to monitoring cardiac function.

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Objective To study the changes of brainstem, visual passage and vascular function in children with migraine during attack. Methods BAEP,VEP and TCD were detected for 30 children with migraine. Results During attack, 47% of BAEP, 77% of VEP and 83% of TCD were found abnormal. The period of wave Ⅰ,Ⅲ,Ⅴ and Ⅲ～Ⅴ in BAEP was prolonged. The latency of P 100 in VEP was prolonged and amplitude was significantly higher. The MCA and ACA of the mean blood velocity in TCD at the headache side was apparently faster. Conclusions These indicated the disturbance of functions such as vision and brain stem in patients with migraine. The blood spasm existed.

Abstract:Objective To study the changes of brainstem, visual passage and vascular function in children with migraine during attack. Methods BAEP,VEP and TCD were detected for 30 children with migraine. Results During attack, 47% of BAEP, 77% of VEP and 83% of TCD were found abnormal. The period of wave Ⅰ,Ⅲ,Ⅴ and Ⅲ～Ⅴ in BAEP was prolonged. The latency of P 100 in VEP was prolonged and amplitude was significantly higher. The MCA and ACA of the mean blood velocity in TCD at the headache side was apparently faster. Conclusions These indicated the disturbance of functions such as vision and brain stem in patients with migraine. The blood spasm existed.

Abstract:Objective To explore Naloxone effect on treating patients with coma through clinical observation of recovery process of the children. Methods 82 children with coma due to various causes were divided into two groups. The control group (n=40) was treated with regular antiinflammation, diuretic, dehydrant, antifebrile and sedatives , while the treatment group (n=42) with Naloxone besides the regular therapy . Results Total effective rate in treatment group was significantly higher than that in control group (59.5% vs. 45%, P<0.05). The in-patient days of treatment group were significantly shorter than of control group (13.7±2.15 d vs. 15.8±2.05 d , P<0.01). Conclusions The finding showed Naloxone was more effective in treating patients with coma and shortened their average days in hospital.

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Objective To explore Naloxone effect on treating patients with coma through clinical observation of recovery process of the children. Methods 82 children with coma due to various causes were divided into two groups. The control group (n=40) was treated with regular antiinflammation, diuretic, dehydrant, antifebrile and sedatives , while the treatment group (n=42) with Naloxone besides the regular therapy . Results Total effective rate in treatment group was significantly higher than that in control group (59.5% vs. 45%, P<0.05). The in-patient days of treatment group were significantly shorter than of control group (13.7±2.15 d vs. 15.8±2.05 d , P<0.01). Conclusions The finding showed Naloxone was more effective in treating patients with coma and shortened their average days in hospital.

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Objective To investigate the study status in children with epilepsy who were accepting the anti-epileptic drugs(AEDs).Methods The sample was collected through 1980 to 1995, totally 500 children withAEDs treated in our clinic were prospectively chosen in radom.All children acception the AEDs treatment for more than 3 years had been studying in primary or middle school. They were regularly followed up for their seizure and their performance in study including 500 children in primary schools,100 children in junior middle schools. 100 children were investigated in their directions after grduating from junior middle schools. Results 477(95.4%) children with epilepsy finally accomplished the courses of primary schools.Comparing 477 epilepsy children with healthy children they were remarkable differences (P<0.05), due to the number of students who failed to go up to higher grade in epilepsy group more than that in healthy group.62 of 100 children with epilepsy graduanting from junior middle schools went up to senior middle schools.The rate of seizure free was 68% within one year after starting treatment.Some of them did exceedingly well in their studies.Conclusions The results would greatly inspirit children with epilepsy, their parents and neurological pediatricians for this chroni disease.This finding also draws attention to the special needs of children with epilepsy in studies,psychological characters and anti-epileptic therapies.All these factors will affect children with epilepsy on their occupational prospects and their quality of life.

Abstract:Objective To investigate the study status in children with epilepsy who were accepting the anti-epileptic drugs(AEDs).Methods The sample was collected through 1980 to 1995, totally 500 children withAEDs treated in our clinic were prospectively chosen in radom.All children acception the AEDs treatment for more than 3 years had been studying in primary or middle school. They were regularly followed up for their seizure and their performance in study including 500 children in primary schools,100 children in junior middle schools. 100 children were investigated in their directions after grduating from junior middle schools. Results 477(95.4%) children with epilepsy finally accomplished the courses of primary schools.Comparing 477 epilepsy children with healthy children they were remarkable differences (P<0.05), due to the number of students who failed to go up to higher grade in epilepsy group more than that in healthy group.62 of 100 children with epilepsy graduanting from junior middle schools went up to senior middle schools.The rate of seizure free was 68% within one year after starting treatment.Some of them did exceedingly well in their studies.Conclusions The results would greatly inspirit children with epilepsy, their parents and neurological pediatricians for this chroni disease.This finding also draws attention to the special needs of children with epilepsy in studies,psychological characters and anti-epileptic therapies.All these factors will affect children with epilepsy on their occupational prospects and their quality of life.

Abstract:Objective To evaluate the effect of calcitonin gene-related peptide(CGRP) intravenous on myocardial injury and the oxygen free radicals in rats. Methods Rat myocardial injury model was established by subcutaneous injection of single dose isoproterenol(ISO), and then treated with CGRP single dose IV. Two hours after treatment, blood was taken for determining serum CK,LDH,MDA and SOD tests,and the myocardial tissue was homogeniged for determining tissue MDA and SOD, and microstructures observation proceeded. Results (1)When group ISO injury was compared with the group control, its serum MDA and tissue MDA levels increased apparently,but its serum SOD and tissue SOD levels decreased (P<0.05). Compared with that in group ISO injury the serum MDA and tissue MDA in CGRP treatment group decreased obviously, but its serum SOD and tissue SOD increased obviously(P<0.05). (2)Serum CK and LDH levels in group treatment decreased clearly as compared with that in group injury (P<0.05). (3) Microstructure observation showed that the injury degree of myocardial structure in group CGRP treatment was much less severe than that in group injuried(P<0.05). Conclusions The results suggest that CGRP has effects of protecting the myocardial injury induced by isoproterenol, correcting the imbalance between MDA and SOD level, inhibiting the stronger lipid hyperoxide reaction, preventing the myocardial enzyme leak from injuried cardiomyocyte and antagonizing arrhythmia in rats.

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Objective To evaluate the effect of calcitonin gene-related peptide(CGRP) intravenous on myocardial injury and the oxygen free radicals in rats. Methods Rat myocardial injury model was established by subcutaneous injection of single dose isoproterenol(ISO), and then treated with CGRP single dose IV. Two hours after treatment, blood was taken for determining serum CK,LDH,MDA and SOD tests,and the myocardial tissue was homogeniged for determining tissue MDA and SOD, and microstructures observation proceeded. Results (1)When group ISO injury was compared with the group control, its serum MDA and tissue MDA levels increased apparently,but its serum SOD and tissue SOD levels decreased (P<0.05). Compared with that in group ISO injury the serum MDA and tissue MDA in CGRP treatment group decreased obviously, but its serum SOD and tissue SOD increased obviously(P<0.05). (2)Serum CK and LDH levels in group treatment decreased clearly as compared with that in group injury (P<0.05). (3) Microstructure observation showed that the injury degree of myocardial structure in group CGRP treatment was much less severe than that in group injuried(P<0.05). Conclusions The results suggest that CGRP has effects of protecting the myocardial injury induced by isoproterenol, correcting the imbalance between MDA and SOD level, inhibiting the stronger lipid hyperoxide reaction, preventing the myocardial enzyme leak from injuried cardiomyocyte and antagonizing arrhythmia in rats.

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Abstract:Objective To summarize the experience in diagnosis and treatment of portal cavernoma in children and inquire its prognosis of different therapies.Methods Analysing the diagnosis and treatment effect on 9 cases with portal caver cavernoma aged 1～11, 7 cases were followed up. Results The first noticed symptoms showed upper digestive tract hemorrahge and splenomegaly. The postive rate of diagnosis of portal cavernoma by ultrasound was 88.9% and false postive rate was 2.3%. The patients under the operation of portacaval shunt and splenectomy had ≤1 episode of upper digestive tract hemorrage per year, which had better outcome than those under only splenectomy or portacaval devescularization and splenectomy. Conclusions The possibility of portal cavernoma should be considered in children with portal hypertension.Ultrasound can be used as an ordinary method in the diagnosis of the cases. Portacaval shunt and splenectomy is the first choice management in the patients when condition is permited.

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Objective To summarize the experience in diagnosis and treatment of portal cavernoma in children and inquire its prognosis of different therapies.Methods Analysing the diagnosis and treatment effect on 9 cases with portal caver cavernoma aged 1～11, 7 cases were followed up. Results The first noticed symptoms showed upper digestive tract hemorrahge and splenomegaly. The postive rate of diagnosis of portal cavernoma by ultrasound was 88.9% and false postive rate was 2.3%. The patients under the operation of portacaval shunt and splenectomy had ≤1 episode of upper digestive tract hemorrage per year, which had better outcome than those under only splenectomy or portacaval devescularization and splenectomy. Conclusions The possibility of portal cavernoma should be considered in children with portal hypertension.Ultrasound can be used as an ordinary method in the diagnosis of the cases. Portacaval shunt and splenectomy is the first choice management in the patients when condition is permited.

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Objective To inquire the technique of Ferguson's operation and the causes of failure in operation. Methods Ferguson's operation was performed on 28 hip joint of 20 cases(male 3, female 17) with congenital dislocation of the hip. The average age of the patients was 18.2 months (ranging from 10 to 32 months). Results Postoperatively, the hip safe zones of 26 hips were 60 ～90, and 2 hips were 30 . The average duration of follow-up was four years and nine months (ranging from nine months to six years and seven nomths). The hip activties of the all patients exceeded 130 degree. Reduction of 26 hips succeeded. Two hips presented subluxation. Five hips presented vascular necrosis of the femoral head; tow hips bring into sight gluteus contracture. Conclusions The major cause of failure was due to the infants' age older and the femoral anteversion angles are larger. The roentgenogram must take in preoperation to measure the femoral anteversion angles. It is proposed that the infants over the age of 30 months and the femoral anteversion angles more than 70 and the closed redution without any feeling should have anterior open reduction instead of an attempt a Ferguson's operation.

Abstract:Objective To inquire the technique of Ferguson's operation and the causes of failure in operation. Methods Ferguson's operation was performed on 28 hip joint of 20 cases(male 3, female 17) with congenital dislocation of the hip. The average age of the patients was 18.2 months (ranging from 10 to 32 months). Results Postoperatively, the hip safe zones of 26 hips were 60 ～90 , and 2 hips were 30 . The average duration of follow-up was four years and nine months (ranging from nine months to six years and seven nomths). The hip activties of the all patients exceeded 130 degree. Reduction of 26 hips succeeded. Two hips presented subluxation. Five hips presented vascular necrosis of the femoral head; tow hips bring into sight gluteus contracture. Conclusions The major cause of failure was due to the infants' age older and the femoral anteversion angles are larger. The roentgenogram must take in preoperation to measure the femoral anteversion angles. It is proposed that the infants over the age of 30 months and the femoral anteversion angles more than 70  and the closed redution without any feeling should have anterior open reduction instead of an attempt a Ferguson's operation.

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