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Objective To analyse the clinical significance of the immunophenotype, aneuploidy and cell circle distribution in children with acute leukemia (AL). Methods With the techniques of flow cytometry (FCM), the immunophenotype and the DNA content in bone marrow mononuclear cells were determined in 42 cases of confirmed AL patients. Results The expression frequency of myeloid antigens in the ANLL group was CD 33 >CD 13 >CD 14 >CD 15 . Both lymphoid and myeloid antigen were expressed in the 4 AL patients with poor prognosis. The percentage of myelocytic circles (S%) in AL patients was significantly lower than in normal controls, indicating hemopoietic hypofunction in AL patients. The S% medium of hypodiploidy in the ALL group was significantly different compared with that of hypodiploidy and diploidy in the ALL group. The S% medium in patients with CD 33 /CD 13 >1 was marked different compared with those with CD 33 /CD 13 <1 in the ANLL group. Conclusions The analysis of immunophenotype, aneuploidy, and cell circle plays an important role in clinical diagnosis, treatment and prognosis.

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Objective To explore the effect of neonatal maturity and postnatal age on serum potassium concentration ([K +]). Methods Serum [K +] in neonates with gestational ages of 24～28 weeks (group A), 29～32 weeks (group B), 33～36 weeks (group C) and 37～42 weeks (group D) were retrospectively analyzed at 1～72 hours after birth. Results ①There was a linear correlation between serum [K +] and the gestational age, birth weight, and urine output in newborns. ②Serum [K +] of group A and B was higher than that of group C and D during the first 24 hours after birth, decreased during the second 24 hours, and reached that of group C and D during the third 24 hours. Serum [K +] in groups C and D did not change significantly during 72 hours after birth. ③Twenty four of the premature infants in groups A, B and C developed hyperkalemia (≥7.0 mmol/L) during the first 24 hours, with an incidence of 20.0%, 12.5% and 4.0%, respectively. After conventional therapy, serum [K +] in 14(58.3%) decreased to less than 7.0 mmol/L within 72 hours (all infants survived), whereas hyperkalemia persisted in 10 infants (41.7%) remained, and 7 died. There was no hyperkalemia in group D during 72 hours after birth. Conclusions Neonatal maturity and postnatal age affect serum potassium concentration. Higher potassium concentration decreases with the increasing of gestational and postnatal age in very premature infants. Critical hyperkalemia exists in premature infants, and conventional therapy is partially effective for the survival of the infants.

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Objective To clarify the clinical feature of complex partial status epilepticus (CPSE) in children. Methods The clinical and EEG manifestations and the treatment with antiepileptic drugs in 17 patients suffering from CPSE were analyzed. Results The age of the onset of symptoms ranged from 3 to 12 years. The clinical attacks lasted a variable time from 1 hour to more than 3 weeks. Definite medical causes were identified in 78% of the patients. Each patient had a prolonged change of consciousness, accompanied by psychological and behavioral changes. The characteristics of ictal EEG in CPSE patients generally included slow activity and δ or θ activity in the temporal region. After antiepileptic drug treatment, the conditions of 11 patients were under complete control, 4 patients had no CPSE but complex partial seizures, and 2 patients had no improvement. Conclusions CPSE may present with confusion, behavioral disturbances and psychiatric conditions. The diagnosis can be made by the ictal or interictal EEG. It is necessary to make the diagnosis and control the seizures as early as possible.

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Objective To asses the effect of anticholinergic agent on the treatment of child asthma and to study the changes in peak expiratory flow rate (PEFR). Methods In the treatment group ipratropium bromide and salbutamol were combined to treat asthmatic children suffering from an acute attack (n=11), while in the control group only salbutamol by inhalation was used (n=9). The changes in PEFR ipratropium were measured. Results After the administration of ipratropium bromide to the treatment group, the percentage of seperately measured PEFR compared to the predicted PEFR were 68.8±5.6%, 72.0±3.4% and 71.1±3.7% after 40, 60 and 80 minutes, respectively. However, the percentages of the control group were 60.6±5.7%, 60.8±6.3% and 59.1 ± 6.7% . There was a significant difference between the two groups (P<0.01). Conclusions Combined ipratropium bromide and salbutamol by inhalation in the treatment of child asthma results in significant improvement in pulmonary function, longer lasting time of bronchodilatory effect and less side effect than salbutamol alone.

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Objective To study the changes of interleukin 6 (IL 6) and tumor necrosis factor (TNF) levels in cerebrospinal fluid (CSF) in children with acute infection of the central nervous system. Methods IL 6 and TNF in CSF were determined using ELISA in 50 children who were admitted with acute infection of the central nervous system, including 18 cases with purulent meningitis (PM) and 32 cases with viral meningitis or encephalitis (VE), and twelve children served as controls. Results The levels of IL 6 and TNF in the PM group (746±499 pg/ml and 565±371 pg/ml, respectively) were significantly higher than that of the VE group (165±176 pg/ml and 75±73 pg/ml, respectively) and the controls (10±17 pg/ml and 21±26 pg/ml, respectively) (P<0.001). The levels of IL 6 and TNF in the VE group were also higher than those of the controls (P<0.01 and P<0.05, respectively). No significant relationship was found between elevations of CSF IL 6 and TNF levels and CSF leukocyte counts. Conclusions The determination of CSF IL 6 and TNF levels may be valuable in distinguishing purulent meningitis from viral meningitis and encephalitis. We speculate that IL 6 and TNF may contribute to the pathophysiological mechanisms of acute infection of the central nervous system.

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Objective To study the excitatory amino acid (EAA) neurotransmitter concentration in bilirubin induced encephalopathy. Methods Guinea pigs with bilirubin-induced encephalopathy were fixed in the stereotaxic frame. The microdialysis probe was inserted in the hippocampus zone, Kreb's ringer was irrigated and extracellular liquid was collected for analyses with high performance liquid chromatography (HPLC). Results The concentration of EAA neurotransmitter Gly in the extracellular liquid of the bilirubin precipitated brain was 21.35±4.87 μM,significantly higher than that in the control group (14.02±1.56μM). EAA neurotransmitter Glu and Asp did not show any significant change in the animal model compared with the control. Conclusions The increase of EAA neurotransmitter Gly concentration in the extracellular liquid of the bilirubin precipitated brain tissues might increase the sensitivity of the ligand Asp and Glu to the NMDA Receptor.

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Objective To elucidate the role of cNOS mRNA expression in the pathogenesis of hypoxic brain injury after neonatal hypoxia. Methods RT PCR was used to measure cNOS mRNA gene expression in brain cells obtained from a neonatal rat model of hypoxia (n=25). Results The expression of cNOS mRNA in both 1 and 4 hour hypoxic groups was both increased compared with that in the control group (P<0.01), but it was decreased in the 4 hour group compared with the 1 hour group (P<0.01). Conclusions NO synthesized by cNOS mRNA in the early hypoxic phase might have some protective effect on hypoxic brain tissues.

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Objective To evaluate three models of intrauterine growth retardation (IUGR) in the rat for use in long term metabolism and development. Methods Fifteen pregnant rats were divided into 3 groups, in which IUGR was produced by either 1)uterine artery ligation, 2)abdominal injection of Dectinomycin, or 3) passive smoking. Newborn rats were delivered vaginally, and their body weights, rates of IUGR and perinatal death rates were compared. Results The average body weight of the newborn rats in each group was 5.546g, 5.377g, 5.103g; the IUGR rates were 27.8% , 42.2%, 61.6%; the perinatal death rates were 61.1%, 17.8%, 6.7%, respectively. Conclusion Both Dactinomycin abdominal injection and passive smoking can successfully establish an IUGR rat model, IUGR actived through passive smoking has a higher rate of fetal growth retardation and a lower mortality rate, suggesting that this may be a preferred model.

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Objective To study familial infectious status of helicobacter pylori (HP) and its effect on the rate of HP infection in children in the same household. Methods Children with abdominal pain and their parents were detected in the way of serology and 13 C -urea breath test (UBT). Results The HP infection rate of the family of 13 C-UBT and serologic HP-IgG was 41.6% and 76.5% respectively, higher than that of children with recurrent abdominal pain, which was 29.5% and 54.8% respectively (P<0.05 and P<0.005). The familial HP infection rate when children were HP positive by 13 C-UBT and serology was 83.7%and 85.7% respectively, much higher than that when children were HP negative, 23.9% and 65.3% respectively; the children's HP infection rates (59.4% using 13 C-UBT and 61.4% using serology) of the family with HP positive were also much higher than that of the family with HP negative, which was 8.3% using serology and with 33.3% using 13 C-UBT, (P<0.005). The sensitivity of serology was 94.2% , and the specificity was 36.1%. Conclusions The symptomatic infection rate of HP in children is high when there is HP infection in family members, 13 C-UBT better reflects the infectious status of HP in a particular family.

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Objective To study the prognosis after early diagnosis and treatment of infants with congenital esophageal atresia (CEA). Methods The treatment in 25 cases with CEA during the 1991～1998 period and the follow up data of 9 infants who survived were retrospectively analyzed. Results Pneumonia occurred in 89.47% of the infants with CEA which was diagnosed 2 days after birth. Anastomotic leaks after surgical operation occurred in 80%(4/5) of the cases in which the distance from the distal to the proximal esophageal pouches was 1.5～3.5 cm. The main causes of death were exacerbated pneumonia and complications secondary to anastomotic leaks after surgical operation. Conclusions Early diagnosis, improved intensive care, management and prevention of postoperative complication at the right moment are the key of successively operation on infants with CEA.

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Objective To develop a temperament questionnaire suitable for infants younger than 4 months in China. Method 400 parents of infants of 1～4 month of age born at 2 different hospitals completed the early infancy temperament questionnaire (EITQ), which originated in America and was revised for Chinese infants. The infants were divided into the 1～2 month group and the 3～4 month group. Results Means for the nine categories were established. Internal consistency for the nine categories ranged from 0.35 to 0.70. Test～retest scores ranged from 0.80 to 0.91. None of the categories showed significant differences between male and female infants. Conclusions The revised EITQ is suitable for 1～4 month old infants in China.

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