Abstract:Objective The purpose of this paper was to study the distribution frequency of immunoglobulin heavy chain gene(IgH) and T cell receptor (TCR)Vδ 2Dδ 3 gene rearrangement in children with acute lymphoblastic leukemia(ALL) in the first visit and the significance in early diagnosis of central nervous system leukemia(CNSL) and monitoring of MRD in CSF.Methods PCR and Nested-PCR techniques were employed to amplify IgH and TCR Vδ 2Dδ 3 fragments from blast cells in bone marrow and from CSF of patients with ALL.Results Twenty three of 32 patients had IgH gene rearrangement and/or TCR Vδ 2Dδ 3 gene rearrangement in bone marrow samples.Nine of 23 CSF samples from patients during remission induction had TCR Vδ 2Dδ 3 gene rearrangement and 4 samples had IgH gene rearrangement. Three of 37 CSF samples from patients in complete remission had IgH gene rearrangement and 7 samples had Vδ 2Dδ 3 gene rearrangement.Conclusions The positive rate of IgH gene rearrangement is 47% and that of Vδ 2Dδ 3 gene rearrangement is 38% in detected samples of bone marrow. Dynamic detection of IgH and Vδ 2Dδ 3 gene rearrangements in CSF of ALL patients by PCR techniques is an effective tool for early clinical diagnosis of CNSL and much more sensitive than CSF routine examination.It plays a guiding role in prevention and prognosis evaluation of CNSL.

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Objective The purpose of this paper was to study the distribution frequency of immunoglobulin heavy chain gene(IgH) and T cell receptor (TCR)Vδ 2Dδ 3 gene rearrangement in children with acute lymphoblastic leukemia(ALL) in the first visit and the significance in early diagnosis of central nervous system leukemia(CNSL) and monitoring of MRD in CSF.Methods PCR and Nested-PCR techniques were employed to amplify IgH and TCR Vδ 2Dδ 3 fragments from blast cells in bone marrow and from CSF of patients with ALL.Results Twenty three of 32 patients had IgH gene rearrangement and/or TCR Vδ 2Dδ 3 gene rearrangement in bone marrow samples.Nine of 23 CSF samples from patients during remission induction had TCR Vδ 2Dδ 3 gene rearrangement and 4 samples had IgH gene rearrangement. Three of 37 CSF samples from patients in complete remission had IgH gene rearrangement and 7 samples had Vδ 2Dδ 3 gene rearrangement.Conclusions The positive rate of IgH gene rearrangement is 47% and that of Vδ 2Dδ 3 gene rearrangement is 38% in detected samples of bone marrow. Dynamic detection of IgH and Vδ 2Dδ 3 gene rearrangements in CSF of ALL patients by PCR techniques is an effective tool for early clinical diagnosis of CNSL and much more sensitive than CSF routine examination.It plays a guiding role in prevention and prognosis evaluation of CNSL.

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Objective To explore the pathogenic effects of granulocyte-macrophage colony-stimulating factor(GM-CSF) in children with pneumonia.Methods The plasma levels of GM-CSF in children (30 cases of slight pneumonia, 20 cases of severe pneumonia complicated by heart failure, and 25 healthy children) were studied by radioimmunoassay.Results The plasma levels of GM-CSF in children with slight and severe pneumonia complicated by heart failure were 12 79±2 02 pg/ml and 9 14±2 39 pg/ml(P<0 01).The levels in the two groups were significantly higher than that in healthy children(7 59±3 13 pg/ml, P<0 01, P<0 05).Conclusions GM-CSF participates in the pathogenesis of penumonia in children.

Abstract:Objective To explore the pathogenic effects of granulocyte-macrophage colony-stimulating factor(GM-CSF) in children with pneumonia.Methods The plasma levels of GM-CSF in children (30 cases of slight pneumonia, 20 cases of severe pneumonia complicated by heart failure, and 25 healthy children) were studied by radioimmunoassay.Results The plasma levels of GM-CSF in children with slight and severe pneumonia complicated by heart failure were 12 79±2 02 pg/ml and 9 14±2 39 pg/ml(P<0 01).The levels in the two groups were significantly higher than that in healthy children(7 59±3 13 pg/ml, P<0 01, P<0 05).Conclusions GM-CSF participates in the pathogenesis of penumonia in children.

Abstract:Objective To identify the effect of simple obestity on cardiovascular system in children. Methods Left ventricular(LV)structure and function were examined with conventional echocardiography and Doppler tissue imaging techniques in 63 children aged from 7 to 14 years with moderate or severe simple obesity (obesity group) and 63 normal weight children of similar age, height and sex proportion (control group).The relationship between LV structure and function and the degree of obesity was analyzed. Results ①LV diastolic dimension(LVDD),interventricular septal thickness(IVS),LV posterior wall(LVPW) thickness and LV mass (LVM) in obesity group increased significantly as compared with control group ( P <0.01), while LVM index(LVMI)had no obvious change ( P >0.05). Stroke index(SI)and cardiac index(CI)decreased significantly ( P <0.01).There were marked changes in transmitral peak flow velocity during the late atrial filling (A peak),E/A, the motion velocity gaps between LV posterior wall's endocardium and epicardium during early diastolic period (DmeVG), mitral annular early and late diastolic velocity (DeV and DaV), and DeV/aV( P <0.01). ② In obesity group, LVM and some indices about diastolic function showed a correlation with body weight and subcutaneous fat thickness ( P <0.05), but no relationship with the ratio of waist to buttock ( P >0.05). ③ LVM was linearly related to DaV and DeV/aV( P <0.05). Conclusions Obesity in children causes left heart hypertrophy and reduces heart function which is correlated with body weight and subcutaneous fat thickness. LVMI has little change in obese children, which differs from adult obesity. Because childhood obesity is characterized of peripheral fat distribution, the ratio of waist to buttcock is not associated with LV hypertrophy or decreased heart function.

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Objective To identify the effect of simple obestity on cardiovascular system in children. Methods Left ventricular(LV)structure and function were examined with conventional echocardiography and Doppler tissue imaging techniques in 63 children aged from 7 to 14 years with moderate or severe simple obesity (obesity group) and 63 normal weight children of similar age, height and sex proportion (control group).The relationship between LV structure and function and the degree of obesity was analyzed. Results ①LV diastolic dimension(LVDD),interventricular septal thickness(IVS),LV posterior wall(LVPW) thickness and LV mass (LVM) in obesity group increased significantly as compared with control group ( P <0.01), while LVM index(LVMI)had no obvious change ( P >0.05). Stroke index(SI)and cardiac index(CI)decreased significantly ( P <0.01).There were marked changes in transmitral peak flow velocity during the late atrial filling (A peak),E/A, the motion velocity gaps between LV posterior wall's endocardium and epicardium during early diastolic period (DmeVG), mitral annular early and late diastolic velocity (DeV and DaV), and DeV/aV( P <0.01). ② In obesity group, LVM and some indices about diastolic function showed a correlation with body weight and subcutaneous fat thickness ( P <0.05), but no relationship with the ratio of waist to buttock ( P >0.05). ③ LVM was linearly related to DaV and DeV/aV( P <0.05). Conclusions Obesity in children causes left heart hypertrophy and reduces heart function which is correlated with body weight and subcutaneous fat thickness. LVMI has little change in obese children, which differs from adult obesity. Because childhood obesity is characterized of peripheral fat distribution, the ratio of waist to buttcock is not associated with LV hypertrophy or decreased heart function.

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Objective To investigate the pathogenic effects and clinical significance of endothelin(ET) and epidermal growth factor(EGF) levels in neonates with pneumonia. Methods The levels of plasma ET and urine EGF were determined by radioimmunoassay in 38 and 26 neonates with pneumonia respectively.Results The levels of plasma ET and urine EGF were significantly higher in the acute stage of pneumonia neonates group than those in the control group ( P <0.01). The levels of ET and EGF were significantly higher in 8 severe cases in acute stage than those in convalescent stage ( P <0.01).The changes of plasma ET were compatible with that of urine EGF in the disease process,and there was a positive correlation between them. Conclusions The results suggested that ET and EGF might have a stimulating effect on the pathogenic course of neonatal pneumonia, and the detection of ET and EGF might be considered as an estimative reference to the prognosis of neonatal pneumonia.

Abstract:Objective To investigate the pathogenic effects and clinical significance of endothelin(ET) and epidermal growth factor(EGF) levels in neonates with pneumonia. Methods The levels of plasma ET and urine EGF were determined by radioimmunoassay in 38 and 26 neonates with pneumonia respectively.Results The levels of plasma ET and urine EGF were significantly higher in the acute stage of pneumonia neonates group than those in the control group ( P <0.01). The levels of ET and EGF were significantly higher in 8 severe cases in acute stage than those in convalescent stage ( P <0.01).The changes of plasma ET were compatible with that of urine EGF in the disease process,and there was a positive correlation between them. Conclusions The results suggested that ET and EGF might have a stimulating effect on the pathogenic course of neonatal pneumonia, and the detection of ET and EGF might be considered as an estimative reference to the prognosis of neonatal pneumonia.

Abstract:Objective The purpose of the present investigation was to evaluate the diagnostic value of cerebral CT and neonatal behavioral neurological assessment(NBNA) in neonatal hypoxic ischemic encephalopathy(HIE).Methods The cerebral CT values and NBNA were examined in fullterm neonates with HIE, and their significance of the changes of values with state of an illness or different classification were explored.Results According to clinical classification, the cerebral CT values and NBNA scores were significantly different between group slight grade HIE and group medium grade.NBNA scores were also significantly different between slight grade HIE and group medium grade if HIE was classificated according to the cerebral CT values.Conclusions Determination of cerebral CT value and assessment of NBNA are helpful to the estimation of the state of HIE.

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Objective The purpose of the present investigation was to evaluate the diagnostic value of cerebral CT and neonatal behavioral neurological assessment(NBNA) in neonatal hypoxic ischemic encephalopathy(HIE).Methods The cerebral CT values and NBNA were examined in fullterm neonates with HIE, and their significance of the changes of values with state of an illness or different classification were explored.Results According to clinical classification, the cerebral CT values and NBNA scores were significantly different between group slight grade HIE and group medium grade.NBNA scores were also significantly different between slight grade HIE and group medium grade if HIE was classificated according to the cerebral CT values.Conclusions Determination of cerebral CT value and assessment of NBNA are helpful to the estimation of the state of HIE.

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Objective The aim of the study was to investigate the pathogenesis of Tourette syndrome(TS) by means of neuropsychology.Methods The neuropsychological tests were performed by Wechsler Intelligence Scale for Chinese-Children Revised(WISC-CR) in 21 children with TS.The results before and after therapy were compared with that of 20 normal children, respectively.Results The scale scores of labyrinth , coding , digit span and scores of lie scale in the TS group were significantly lower than those in normal children ( P <0.05), but there was no obvious diffence between the group TS and the normal group in the total intelligence , language intelligence, and operating intelligence.There was no obvious change in the status of the TS group after treatment. Conclusions Children with TS have neuropsychological deficit in various degrees and in addition to administration of medicine, psychological treatment is necessary.

Abstract:Objective The aim of the study was to investigate the pathogenesis of Tourette syndrome(TS) by means of neuropsychology.Methods The neuropsychological tests were performed by Wechsler Intelligence Scale for Chinese-Children Revised(WISC-CR) in 21 children with TS.The results before and after therapy were compared with that of 20 normal children, respectively.Results The scale scores of labyrinth , coding , digit span and scores of lie scale in the TS group were significantly lower than those in normal children ( P <0.05), but there was no obvious diffence between the group TS and the normal group in the total intelligence , language intelligence, and operating intelligence.There was no obvious change in the status of the TS group after treatment. Conclusions Children with TS have neuropsychological deficit in various degrees and in addition to administration of medicine, psychological treatment is necessary.

Abstract:Objective To study the changes of Liopoprotein (a) in 96 children with a family history of either myocardial infarction or cerebrovascular events. Methods Enzyme Linked Immunosorbent Assay(ELISA) was used to determine Lp(a).Results The level of Lp(a) markedly increased in children with a family history of myocardial infarction as compared with normal controls, meanwhile, the level of Lp(a) did not markedly increase in children with a family history of cerebrovascular events.Conclusions (1) It is necessary for children with a family history of myocardial infarction to have a test and to follow up for Lp(a) at the appropriate time. (2) Continued studies are being conducted on the changes of Lp(a) in children with a family history of cerebrovascular events.

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Objective To study the changes of Liopoprotein (a) in 96 children with a family history of either myocardial infarction or cerebrovascular events. Methods Enzyme Linked Immunosorbent Assay(ELISA) was used to determine Lp(a).Results The level of Lp(a) markedly increased in children with a family history of myocardial infarction as compared with normal controls, meanwhile, the level of Lp(a) did not markedly increase in children with a family history of cerebrovascular events.Conclusions (1) It is necessary for children with a family history of myocardial infarction to have a test and to follow up for Lp(a) at the appropriate time. (2) Continued studies are being conducted on the changes of Lp(a) in children with a family history of cerebrovascular events.

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Abstract:Objective The purpose of the study was to investigate the variations of serum interferon-α (IFN-α),interleukin-8(IL-8)and tumor necrosis factor-α (TNF-α)in children aged from 6 month to 2 years with simple or complex febrile convulsion.Methods The serum IFN-α,IL-8 and TNF-α levels in 64 children cases of simple febrile convulsion and 52 children cases of complicated febrile convulsion were detected by Enzyme Linked Immunosorbent Assay (ELISA) and the relationship between serum IL-8 and TNF-α levels was studied. Results In the group of simple febrile convulsion, the levels of serum IFN-α, IL-8 and TNF-α were 467.68±112.46 ng/L, 48.74±16.5 ng/L and 578.24±168.46 ng/L, respectively, which were obviously higher than those in the control group (P<0 01). The levels of serum IFN-α,IL-8 and TNF-α in the group of complicated febrile convulsion were 584.56±124.24 ng/L,74.38±18.74 ng/L and 812.36±232.38 ng/L, respectively, which were significantly higher than those in control group (P<0 01) and simple febrile convulsion group ( P < 0 01 ). There was a positive correlation between serum IL-8 and TNF- α in simple or complicated febrile convulsion ( r 1=0.565,r 2 =0.64,P<0 01). Conclusions ①In cases of simple or complicated febrile convulsion, serum IFN- α, IL-8 and TNF-α levels are increased obviously. It can enhance body's immunity to infection, on the other hand,it may irritate immunological inflammatory reaction, thus causing tissue and cell damages. ② IL-8 and TNF- α may cooperate in febrile convulsion and be involved in the whole pathological process.

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Objective The purpose of the study was to investigate the variations of serum interferon-α (IFN-α),interleukin-8(IL-8)and tumor necrosis factor-α (TNF-α)in children aged from 6 month to 2 years with simple or complex febrile convulsion.Methods The serum IFN-α,IL-8 and TNF-α levels in 64 children cases of simple febrile convulsion and 52 children cases of complicated febrile convulsion were detected by Enzyme Linked Immunosorbent Assay (ELISA) and the relationship between serum IL-8 and TNF-α levels was studied. Results In the group of simple febrile convulsion, the levels of serum IFN-α, IL-8 and TNF-α were 467.68±112.46 ng/L, 48.74±16.5 ng/L and 578.24±168.46 ng/L, respectively, which were obviously higher than those in the control group (P<0 01). The levels of serum IFN-α,IL-8 and TNF-α in the group of complicated febrile convulsion were 584.56±124.24 ng/L,74.38±18.74 ng/L and 812.36±232.38 ng/L, respectively, which were significantly higher than those in control group (P<0 01) and simple febrile convulsion group ( P < 0 01 ). There was a positive correlation between serum IL-8 and TNF- α in simple or complicated febrile convulsion ( r 1=0.565,r 2 =0.64,P<0 01). Conclusions ①In cases of simple or complicated febrile convulsion, serum IFN- α, IL-8 and TNF-α levels are increased obviously. It can enhance body's immunity to infection, on the other hand,it may irritate immunological inflammatory reaction, thus causing tissue and cell damages. ② IL-8 and TNF- α may cooperate in febrile convulsion and be involved in the whole pathological process.

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Abstract:Objective To search for a new therapy for idiopathic thormbocytopenic purpura(ITP) in children, cortisone therapy was replaced by Ginseng and Radix aconiti praeparata injection (GRA). Methods Chinese traditional medicine combined with Western medicine was adopted to observe the effect of Ginseng and Radix aconiti praeparata injection on 31 cases of ITP. 27 randomly selected cases treated with cortisone were compared with the 31 cases without special treatment at the same time. Results Obvious increase in the Platelet and CD 4 +/CD 8 + was found in the treatment groups of GRA or GRA plus cortisone as compared with the cortisone treatment or control group(both P <0.01).Conclusions GRA and GRA plus cortisone treatment are better than cortisone in the treatment of ITP and its clinical application is desirable.

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Objective To search for a new therapy for idiopathic thormbocytopenic purpura(ITP) in children, cortisone therapy was replaced by Ginseng and Radix aconiti praeparata injection (GRA). Methods Chinese traditional medicine combined with Western medicine was adopted to observe the effect of Ginseng and Radix aconiti praeparata injection on 31 cases of ITP. 27 randomly selected cases treated with cortisone were compared with the 31 cases without special treatment at the same time. Results Obvious increase in the Platelet and CD 4 +/CD 8 + was found in the treatment groups of GRA or GRA plus cortisone as compared with the cortisone treatment or control group(both P <0.01).Conclusions GRA and GRA plus cortisone treatment are better than cortisone in the treatment of ITP and its clinical application is desirable.

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Objective To better understand the potential role of β-endorphin (β-EP) in the pathogenesis of infection brain edema(IBE) , the present study was to investigate the changes of β-EP and the influence of Jinerlun, a β-EP blocker, on a rabbits model of IBE. Methods Experimental IBE was induced by pertussis bacilli in rabbits. Tweenty-one rabbits were divided randomly into three groups:①Normal saline group (NS, n =7),②Pertussis bacilli group (PB,n=7) and ③Jinerlun group (JEL, n =7) . Water content(WC),Evans Blue concentration (EB) in brain tissue and β-EPwere measured in plasma,cerebrospinal fluid(CSF),cortex and hippocampus in three groups respectively. Results WC and EB were significantly higher in the PB group than those in the NS group and JEL group ( P <0.01).β-EP of the plasma , CSF , cortex and hippocampus were significantly higher in the PB group than those in the NS group (106.33±24.96 ng/ml vs 43.80±19.63 ng/ml, 2.49±0.66 ng/ml vs 1.14±0.39 ng/ml, 56.28±11.66 ng/mg vs 18.50±2.01 ng/mg, 85.97±33.76 ng/mg vs 22.52±6.09 ng/mg, P <0.01, respectively) and in the JEL group (106.33±24.96 ng/ml vs 69.38±4.67 mg/ml, 2.49±0.66 ng/ml vs 1.44±0.26 ng/ml, 56.28±11.66 ng/mg vs 31.16±7.01 ng/mg, 85.97±33.76 ng/mg vs 45.03±9.98 ng/mg, P <0.01, respectively). Conclusions β-EP involves in the pathophysiologic processes of the experimental IBE, and Jinerlun plays an important role in amelioration of β-EP increase and IBE.

Abstract:Objective To better understand the potential role of β-endorphin (β-EP) in the pathogenesis of infection brain edema(IBE) , the present study was to investigate the changes of β-EP and the influence of Jinerlun, a β-EP blocker, on a rabbits model of IBE. Methods Experimental IBE was induced by pertussis bacilli in rabbits. Tweenty-one rabbits were divided randomly into three groups:①Normal saline group (NS, n =7),②Pertussis bacilli group (PB,n=7) and ③Jinerlun group (JEL, n =7) . Water content(WC),Evans Blue concentration (EB) in brain tissue and β-EPwere measured in plasma,cerebrospinal fluid(CSF),cortex and hippocampus in three groups respectively. Results WC and EB were significantly higher in the PB group than those in the NS group and JEL group ( P <0.01).β-EP of the plasma , CSF , cortex and hippocampus were significantly higher in the PB group than those in the NS group (106.33±24.96 ng/ml vs 43.80±19.63 ng/ml, 2.49±0.66 ng/ml vs 1.14±0.39 ng/ml, 56.28±11.66 ng/mg vs 18.50±2.01 ng/mg, 85.97±33.76 ng/mg vs 22.52±6.09 ng/mg, P <0.01, respectively) and in the JEL group (106.33±24.96 ng/ml vs 69.38±4.67 mg/ml, 2.49±0.66 ng/ml vs 1.44±0.26 ng/ml, 56.28±11.66 ng/mg vs 31.16±7.01 ng/mg, 85.97±33.76 ng/mg vs 45.03±9.98 ng/mg, P <0.01, respectively). Conclusions β-EP involves in the pathophysiologic processes of the experimental IBE, and Jinerlun plays an important role in amelioration of β-EP increase and IBE.

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Objective To evaluate the causes, treatment and outcome of cardiac tamponade or compression and heart beat arrest after open heart surgery in children. Methods Eighteen cases of cardiac tamponade or compression and heart beat arrest underwent open chest treatment at bedside in ICU. Cardiac tamponade caused by bleeding was found in 7, nonbleeding cardiac compression in 6, acute blood volume reduction in 2,and heart beat arrest due to arrhythmia in 3. Cardiac tamponade and heart beat arrest in 14 patients occurred within 4 hours postoperation.Results The initial stage of resuscitation in all cases was successful. Fifteen survivors were well recovered without any complication. Three patients died of uncontrollable heart failure. Conclusions The satisfactory result may be obtained by the bedside open chest emergency treatment of cardiac tamponade, compression or cardiac arrest after cardiac operation.

Abstract:Objective To evaluate the causes, treatment and outcome of cardiac tamponade or compression and heart beat arrest after open heart surgery in children. Methods Eighteen cases of cardiac tamponade or compression and heart beat arrest underwent open chest treatment at bedside in ICU. Cardiac tamponade caused by bleeding was found in 7, nonbleeding cardiac compression in 6, acute blood volume reduction in 2,and heart beat arrest due to arrhythmia in 3. Cardiac tamponade and heart beat arrest in 14 patients occurred within 4 hours postoperation.Results The initial stage of resuscitation in all cases was successful. Fifteen survivors were well recovered without any complication. Three patients died of uncontrollable heart failure. Conclusions The satisfactory result may be obtained by the bedside open chest emergency treatment of cardiac tamponade, compression or cardiac arrest after cardiac operation.

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