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OBJECTIVE: To investigate the effects of resuscitation using oxygen of three concentrations on changes of cerebral intraand extracellular calcium, sodium and potassium in asphyxiated fetal rats. METHODS: Fifty-six fetal rats of twenty-day gestational age were randomly divided into five groups: sham operation (control, n=11), room-air resuscitation (n=10), and oxygen-resuscitated group Ｉ, Ⅱ, Ⅲ (n=14, 11, and 10 respectively) of different oxygen-inhaled concentrations and different oxygen timings. The fetal rats in the latter four groups suffered from ischemia and hypoxia in-uteri resulting from interruption of placental circulation. After recirculation, intra- and extra-cellular concentrations of calcium, sodium, and potassium in the brains were measured in each group. RESULTS: Intracellular free calcium concentrations of fetal rat brains in the room air resuscitation group and the oxygen-resuscitated group I (oxygen-inhaled concentration was 92.8%) were (552.08±93.50) nmol/L and (520.61±79.08) nmol/L respectively. They were similar and both significantly higher than those in the control (315.27±86.88) nmol/L (P<0.01). After resuscitation with 65% oxygen, no matter whether it started before (group Ⅱ) or at the beginning of hypoxia (group Ⅲ), their intracellular free calcium concentrations ［(441.46±47.93) nmol/L and (452.93±36.38) nmol/L respectively］ were significantly lower than those in the room-air resuscitation group (P<0.01) and group I (P<0.05), though still higher than those in the control. There was generally no difference in the total concentrations of calcium, sodium, or potassium among all groups. CONCLUSIONS: Resuscitation with oxygen of different concentrations produced different results: Resuscitation with 92.8% oxygen or room air had a similar effect on the parameters measured, indicating that resuscitation of asphyxiated neonates using pure oxygen might not be superior to that using room air; With lower cerebral intracellular calcium concentrations, resuscitation with 65% oxygen might produce a better outcome compared with that using pure oxygen or room air.

Abstract:OBJECTIVE: The previous experiments of our department had demonstrated that Baicalin (BC) and Tetramethylphyrazine (TMPZ) had protective effect against infectious brain edema in rats and rabbits. In the present study we would look for whether BC and TMPZ could influence HSP70 expression with heat shock responres(HSR). METHODS: Twentyseven male rats were randomly divided into: ①NS group (n=3); ②HSR+pertusis bacillil (PB) group (n=3); ③PB group (n=3); ④BC group, in which the rats were subdivided into three groups (n=3 in each group) with BC injected intraperitoneal at 48 mg/kg, 120 mg/kg, 194 mg/kg respectively. ⑤TMPZ group, 9 rats were evaluated as follows, with 37.5 mg/kg, 100 mg/kg, 160 mg/kg TMPZ injected intraperitoneal respectively. The animals were killed after 28 hours and the expression of HSP 70 was evaluated by western blot analysis. RESULTS: HSP70 in the brain tissues was significantly elevated in the HS+PB group and 120 mg/kg BC, 194 mg/kg BC, 100 mg/kg TMPZ, 160 mg/kg TMPZ groups. HSP70 was only at base levels in the PB and NS groups and 48 mg/kg BC, 37.5 mg/kg TMPZ groups. CONCLUSIONS: BC and TMPZ could influence HSP70 expression with HSR. The protective mechanism of BC and TMPZ on infectious brain edema in rats may be associated with the increase of HSP70 synthesis.

Abstract:OBJECTIVE: To explore the possibility of making an early diagnosis on Kawasaki disease (KD). METHODS: Medical records of 69 children with KD were reviewed retrospectively. Diagnosis of KD was based on current diagnostic criteria of KD. RESULTS: In the 69 cases of KD the incidence of fever, lips injection and/or cheilosis, skin rashes, and bilateral nonexudative conjunctival injection were 100%, 92%, 84% and 81% respetfively within 5 days since onset. The incidence of the perianal skin redness and/or desquamation appeared in 8 days after onset and BCG inoculation scar reaction——“BCG scar” reaction appeared earlier (in 3 days after onset). CONCLUSIONS: When a child developed the Kawasaki appearance—fever, bilateral nonexudative conjunctival injection and lips injection and/or cheilosis in the early stage of febrile illness, KD should be highly suspected. “BCG scar reaction” and the perianal skin redness, even desquamation may be helpful to make an early diagnosis of KD.

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Abstract:OBJECTIVE: To investigate the therapeutic effect of hyperbaric oxygen (HBO) on experimental piglet hypoxic ischemic brain damage (HIBD) and its protective mechanism by using piglets as the animal model for HIBD in newborns. METHODS: Using Levine's method, thirty 7 day old HIBD piglets were randomly divided into the control group and the HBOtreated group in which the piglets were treated with HBO for 3 hours daily. Half of the piglets in each group were sacrificed on the 1st and 7th day after hypoxic ischemic (HI) injury respectively. For these two groups, we observed (1) the mortality and neurological symptoms; (2) the velocity of blood flow in the right carotid artery (rVCA); (3) the brain weight; (4) the quantitative analysis of subdiploid cells in the brain by flow cytometry. RESULTS: The mortality and the incidence of neurological symptoms in the HBO treated group were less than those in the control group (P<0.05). The brain weights in the two groups were not different significantly (P>0.05). The rVCA in the HBO treated group was faster significantly than that in the control group when the first HBO therapy ended ［(146.8±16.8) ml/min vs (123.9±27.6) ml/min］(P<0.01). The ratio of subdiploid cells to all cells in the HBO group was less than that in the control group in the bilateral hippocampus on the 1st and 7th day after HI, and in the left frontoparietal cortex on the 1st day after HI. CONCLUSIONS: HBO therapy is effective on HIBD, and should be recommended as a shortterm and early treatment.

Abstract:OBJECTIVE: To find the best pressure and time of hyperbaric oxygenation (HBO) therapy by comparing different pressures and times in a rat model of neonatal hypoxic ischemic brain damage (HIBD) and to provide the mechanisms of HBO therapy for neonatal clinical application. METHODS: 7day old SD rats were randomly divided into a control(CON) group, HIBD group and HBO group. The HBO group was divided into 7 subgroups according to the different HBO pressure: 1 ATA(H 1.0)，1.25 ATA(H 1.25), 1.5 ATA(H 1.5), 1.75 ATA(H 1.75), 2 ATA(H 2.0), 2.25 ATA(H 2.25) and 2.5 ATA(H 2.5) group. After choosing the best pressure we divided the rats into two groups according to the different HBO time: 30 min group (H 30 min) and 60 min group (H 60 min). All the rats(14dayold) were killed at 7 days after HI. Body weight increasing, left/right brain weight ratio, neuropathologic examination and superoxide dismutase(SOD) and malondialdehyde(MDA) content in brain tissue were measured in each group. RESULTS: ①The weight increasing rate ［(72.91±21.27)%］ and the left/right brain weight ratio (0.6444±0.1599) decreased obviously. At the same time the content of SOD ［(203.32±57.18) NU/ml］ in brain tissue decreased and that of MDA ［(4.197±0.683) nmol/ml］ increased in HIBD group. All above data showed a more significant difference in HIBD group compared to the control group ［weight increasing rate=(104.97±17.34)%，left/right brain weight ratio=0.9857±0.0396，SOD content=(261.53±41.38) NU/ml，MDA content=(3.393±0.574) nmol/ml］(P<0.01). ②Following the increasing HBO pressure the weight increasing rate and left/right brain weight ratio gradually increased, the content of SOD in brain tissue increased and that of MDA decreased, and to the best in H 2.0 group ［left/right brain weight ratio=0.8583±0.1544，SOD content=(259.20±45.22) NU/ml，MDA content=(3.462±0.498) nmol/ml, compared to HIBD group, P<0.01 or <0.05］. ③The weight increasing rate, left/right brain weight ratio, the content of SOD and MDA were higher in H 60min group than in H 30min group, but there was no significant difference between the two groups (P>0.05). CONCLUSIONS: HBO of 2.0 ATA pressure and 30～60 min steady time may have the best effect, and reasonable HBO treatment can increase SOD content and decrease MDA content in brain tissue in HIBD neonatal rats.

Abstract:OBJECTIVE: To study the effect of endogeneous ganglioside (GS) on the adhesion of LA-N5 neuroblastoma cells to collagen. METHODS: LA-N5 cells were cultured in the presence of D-threo 1-phenyl 2-decanolamino 3-morphinoline 1-propanol (D PDMP), an inhibitor of glucosylceramide synthase. The adhesion of the LA N5 cells to immobilized collagen was tested. RESULTS: After 6 days, endogenous GS was reduced by 98%. No change in the cell morphology, viability, proliferation rate or percentage of apoptotic cells was observed. The adhesion to collagen of cells exposed to D PDMP was reduced by 65% compared to the control LA-N5 cells: OD 5700.07±0.01 vs 0.21±0.030(P<0.01). When GS depleted cells were pre incubated in a conditioned medium collected from the control cells, the adhesion to collagen was restored and was comparable to that of the control cells (P>0.05). Similarly, the pre incubation of GS depleted cells with purified tumor GS GD-2, the most abundant GS in LA-N5 cells, restored adhesion. CONCLUSIONS: Endogenous tumor GS regulates neuroblastoma cell adhesion to collagen, suggesting that it may play a role in tumor cell migration, invasion and metastasis.

Abstract:OBJECTIVE: To study the effect of various concentrations of tobacco smoke exposure in the environment on cerebral apoptosis gene expression in pup rats in utero and postnatally. METHODS: Pregnant SD rats were exposed to air or to different concentrations of smoke for 5 hours daily, 7 days a week from day 2 of pregnancy until delivery. Then their pups were exposed to the same environment of passive smoking till weaning. Rapid competitive reverse transcriptasePCR was used to analyze the relative expression of Bax mRNA and Bcl-2 mRNA semi quantitatively of the cerebral hemisphere in the pups. RESULTS: The relative expressions of Bax mRNA of the cerebral hemisphere was 0.31 in the control group, 0.47 in the low concentration group, 0.55 in the moderate concentration group, and 0.60 in the high concentration group. It was significantly higher in the moderate and high concentration groups than that in the control group (P<0.05). The relative expressions of Bcl-2 mRNA were of no significant difference among the passive smoking groups and the control group. CONCLUSIONS: The increase of the relative expression of BaxmRNA in the pups' brain shows that cell apoptosis may play a role in brain damage of rats with passive smoking from intrauterine life to weaning.

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OBJECTIVE: To investigate the effects of intracerebroventricular injection of recombinant murine leptin on the food intake, body weight and blood lipids in diet induced obese rats and normal rats. METHODS: Male SD rats were put on a standard diet (n=15) and highnutrition diet (n=20) for 7 weeks. After 7 weeks, the rats received cannulas implanted into the right lateral ventricles. Allowed 7 days to recover, the rats received an intracerebroventricular injection of recombinant murine leptin (5 μg/rat) for 5 days. On each test day, the body weight and food intake were measured before the injection. Blood lipids were measured after the experiment. RESULTS: ① The body weight of the rats on the highnutrition diet was more significantly increased than that in the normal rats. At the end of the 7th week, the body weight of each group was (342.05±39.27) g and (302.87±31.93) g (P<0.01), with an increase of (270.00±39.99) g and (226.13±30.04) g (P<0.01), respectively. In the dietinduced obese rats, the inhibition of body weight and food intake was observed after the intracerebroventricular leptin injection on the 1st day, more significant on the 5th day ［body weight from (336.3±52.1) g to (287.9±53.4) g (P<0.01), and a decrease of (48.4±17.9) g; food intake from (35.6±13.7) g to (21.1±11.8) g (P<0.01), a decrease of (14.6±4.8) g］. But in the normal group, the effects were observed on the 3rd day ［body weight from (294.5±29.9) g to (269.5±30.9) g (P<0.05), a decrease of (25.0±17.8) g; food intake from (31.0±3.5) g to (25.6±3.6) g (P<0.05), a decrease of (5.3±3.3) g］. ② In the obesity group with leptin administration, the levels of TC, TG and LDL-C decreased more significantly than those in the normal control group ［TC (1.51±0.27) mmol/L vs. (2.22±0.36) mmol/L, P<0.01; TG (0.43±0.06) mmol/L vs. (0.76±0.17) mmol/L; LDL (0.47±0.12)mmol/L vs. (0.86±0.20) mmol/L, P<0.01］. But there was no obvious change of HDL-C in any of the groups. CONCLUSIONS: Recombinant leptin could reduce the body weight and blood lipids, and inhibit the food intake in dietinduced obese rats after intracerebroventricular injection, and also had a certain effect on normal rats.

Abstract:OBJECTIVE: To study the immune function of T-lymphocyte and erythrocyte in the peripheral blood of children with febrile convulsion. METHODS: Eighty two children with typical febrile convulsion, 40 children with acute upper respiratory tract infection (URI) and 40 normal children were enrolled. The proliferation reaction of T-lymphocyte to PHA, distribution of T-lymphocyte phenotype subsets, expression of activation markers CD25 (IL-2R) and HLA-DR, and level of γ-interferon induced by PHA were assayed. Erythrocyte immune function was simultaneously measured by rosette formation rates of RBC-C3bR and RBC-IC. RESULTS: The counts per minute (CPM) and stimulation index (SI), the measurements expressing T-lymphocyte proliferation assay in simple febrile convulsion (SFC) children, were 5 609.4±3 587.4 and 20.5±15.6, and 2 817.3±2 422.8 and 11.0±8.4 in complex febrile convulsion (CFC) children. They were significantly lower than those in the normal controls (20 305.9±12 810.3 and 69.2±45.2) and in the URI group (9 785.2±7 509.8 and 44.5±39.8) (P<0.05). The CD3, CD4 and CD4/CD8 ratio in the SFC children were (40.0±8.2)%, (26.1±9.0)% and 1.1±0.4 and (932.8±6.9)%, (17.8±4.9)% and 0.8±0.1 in the CFC children. They were all significantly lower than those in the normal controls ［(64.1±6.7)%, (47.7±5.5)% and 1.9±0.8］ and in the URI group ［(63.0±9.3), (42.4±8.2)% and 1.6±0.4］ (P<0.01). The expression rates of CD25 (IL-2R) and HLA-DR antigen in the spontaneous condition in the SFC children were (8.9±3.6)% and (16.2±5.6)% and (6.3±1.9)% and (12.4±3.4)% in the CFS children. They were lower than those in the normal controls ［(12.8±2.5)% and (20.2±5.2)%］and in the URI group ［(15.0±3.0)% and (20.5±2.8)%］ (P<0.01) and there were also differences in the SFC children and in the CFS children (P<0.05). After PHA induction, the expression rates of CD25 (IL-2R) and HLA-DR antigen in the SFC children were (57.0±5.1) and (57.8±6.0) and (53.0±12.0)% and (54.7±9.7)% in the CFC children. They were significantly lower than those in the normal controls ［(65.7±5.7)% and (68.8±6.2)%］ (P<0.05) and in the URI group ［(64.3±6.4)% and (67.1±8.6)%］(P<0.01). The γ-IFN level of PBMC induced by PHA in the SFC and CFC children ［(1.80±0.4) and (1.6±0.1) ng/ml］ was significantly lower than that in the normal controls ［(2.4±0.9) ng/ml］(P<0.05). No difference was found compared with the URI group. The rate of rosette formation of RBC-C3b in the SFC children was (9.1±4.9)% and it was significantly lower than that in the normal controls and the URI group ［(15.8±5.7)% and (13.5±5.1)%］(P<0.01), but there was no difference in the SFC children, the normal controls and the URI group. The rate of rosette formation of RBCIC in the SFC children and the CFC children ［(3.0±1.0) and (2.6±0.7)%］ was significantly lower than that in the normal controls ［(3.7±1.3)%］ and the URI group ［(3.9±1.4)%］(P<0.05). CONCLUSIONS: Both T-lymphocyte immune function and erythrocyte immune function in the children with FC were significantly impaired. The impair was more severe in the CFC children than that in the SFC children.

Abstract:OBJECTIVE: To detect the levels of interleukin8 (IL-8) and tumor necrosis factor (TNF) in the cerebrospinal fluid (CSF) in children with purulent meningitis (PM) and viral encephalitis(VE). METHODS: Levels of IL-8 and TNF in CSF were determined using ELISA in 20 children with (PM), 17 children with viral meningoencephalitis (VME), 25 children with (VE), and 15 normal children who served as the controls. RESULTS: The levels of CSF IL-8 and TNF in the PM group ［(443±247) ng/L and (640±283) ng/L］ were significantly higher than those in the VME group ［(184±86) ng/L and (154±95) ng/L］, VE group ［(54±36) ng/L and (30±26) ng/L］ and control group ［(27±20) ng/L and (24±21) ng/L］(P<0.01). The levels of CSF IL-8 and TNF in the VME group were also significantly higher than those in the VE group and control group (P<0.01). CSF IL-8 levels in the VE group were higher than those in the control group (P<0.05), but there was no significant elevation in CSF TNF concentrations. A significantly positive correlation was found between IL-8 and TNF in the PM and VME groups (r=0.682, P<0.01 and r=0.534, P<0.05, respectively). CSF IL-8 levels were significantly related to neutrophil counts in patients with PM (r=0.777, P<0.01), but no significant relationship was shown between CSF IL-8 levels and neutrophil counts in children with VME and VE. There was no correlation between CSF TNF concentrations and neutrophil counts in the three patient groups. Nor was there any correlation between CSF IL-8 and TNF levels and other inflammatory parameters including CSF mononuclear cell counts, and protein and sugar levels in the three patient groups. CONCLUSIONS: IL-8 and TNF are important mediators in the meningeal inflammatory process in children with meningitis. The determination of IL-8 and TNF levels may be valuable in the diagnosis of purulent meningitis.

Abstract:OBJECTIVE: To study the lung function changes of infants with pneumonia via tidal breathing pattern analysis before and after treatment. METHODS: Tidal Flow Volume Loops(TFV) were measured using the tidal breathing pattern in 58 infants (1～40 months old) with pneumonia. Sixty three normal infants were used as controls. The parameters, including respiratory rate (RR), inspiratory and expiratory time (Ti, Te), the ratio of Ti/Te, peak tidal expiratory flow (PTEF), the ratio of time to reach peak tidal expiratory flow (TPTEF)to total expiratory time (TE), the ratio of volume to reach peak tidal expiratory flow (VPEF) to total expiratory volume (VE), tidal volume per kilogram (VT/kg), mean inspiratory flow (MIF), mean expiratory flow (MEF), and tidal expiratory flow at 25%, 50%,75% lung volume(TEF 25%, TEF 50% and TEF 75%) were measured using the MasterscreenPaediatric (a tool for the lung function test). RESULTS: RR increased, TPTEF, TPTEF/TE, VPEF, VPEF/VE were lower in infants with pneumonia compared with those ofthe controls ［RR= (36±9)/min vs (30±8)/ min, TPTEF= (0.20±0.08) s vs (0.40±0.16) s, TPTEF/TE=(18.8±5.8)% vs (33.0±7.5)%, VPEF=(17.2±10.9) ml vs (25.4±12.8) ml, VPEF/VE=(22.1±4.6)% vs (33.4±6.35)%］(P<0.01). TI,TE, TI/TE were shortened. It appeared that the airway was obstructive. After the routine therapy, RR decreased to (33±11)/min, TPTEF/TE and VPEF/TE were significantly higher ［(26.2±8.7) and (8.4±7.3)% , respectively］(P<0.01). CONCLUSIONS: Tidal breathing pattern can be used to evaluate the lung function and the effect of therapy in infants with pneumonia.

Abstract:OBJECTIVE: To study the efficacy of pulmonary surfactant (Exosurf) in the prevention of the neonatal respiratory distress syndrome (RDS) in preterm infants. METHODS: A prospective clinical trial was conducted. To prevent RDS, a single dose of pulmonary surfactant (Exosurf) was administered intratracheally in 25 preterm infants at a high risk of developing RDS as the prophylaxis group, and another 25 preterm babies who received no surfactant administration formed the control group. RESULTS: The preterm infants in the prophylaxis group received a prophylactic dose of surfactant (67.5 mg/kg) within 0.25 to 6 hours (3.4±1.9 hours) after delivery. Oxygenation in these babies was markedly improved and their clinical symptoms were relieved after the administration of surfactant. The durations of supplemental oxygen administration, assisted ventilation and hospitalization in the prophylaxis group, were (9.5±6.9) days, (2.6±3.8) days and (40.8±17.8) days respectively, which were significantly shortened compared with those of the control group (P<0.05). Although the incidence of RDS and mortality in the prophylaxis group (20% and 8%) seemed to be lower than those of the control group (32% and 12%)，there was no statistical differenc (P>0.05). CONCLUSIONS: Prophylactic administration of surfactant can improve oxygenation, relieve symptoms, and shorten the duration of supplemental oxygen administration, assisted ventilation and hospitalization. It has a relief effect on RDS in preterm infants.