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OBJECTIVE: To observe the dynamic changes of nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) and the protective effect of dexamethasone (Dex) on the liver when Lipopolysaccharide (LPS) induces hepatic injuries in neonatal rats. METHODS: One hundred and twenty seven day neonatal rats were divided into the control group (Group A), LPS group (Group B), and Dex group (Group C). Group B rats received 5 mg/kg LPS intraparitoneally. Group C was given LPS 5 mg/kg+Dex 5 mg/kg, and Group A was injected with normal saline of the same volume. NO and MDA contents and SOD activity were detected by the biochemical method in the liver tissues at different times. At the same time, the structural changes of the liver were observed under the light microscope and electron microscope. RESULTS: ① NO and MDA contents increased in Group B compared with Group A. NO content reached its maximum [( 2.58 ± 0.31 ) μmol/g.pro] at 6 h after LPS was given (P< 0.01 ); MDA content reached its maximum ( 2.61 ± 0.50 ) nmol/mg.pro] at 4 h after LPS was given (P< 0.05 ). SOD activity in Group B decreased as time was increasing compared with Group A. It dropped to its minimum [( 118.96 ± 12.81 ) NU/mg.pro] at 24 h (P< 0.01 ). NO and MDA contents decreased significantly and SOD activity increased significantly at 4 h and 6 h in Group C compared with Group B (P< 0.05 or 0.01 ). ② In group B, a large amount of inflammatory cell infiltration in liver tissues were noted and hepatic cells showed spotty necrosis and bleeding under the light microscope; the electron microscope showed a significant decrease of mitochondria cristae, the broadness of endoplasmic reticula, hepatic cell necrosis and karyopyknosis. The structural changes were alleviated in Group C. CONCLUSIONS: LPS could cause changes of NO and MDA contents and SOD activity in hepatic tissues. Dex might inhibit NO production and get rid of oxygen free radicals so that it can protect the liver from injuries.

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OBJECTIVE: To investigate the relationship between apoptosis and necrosis of myocardial cells in murine myocarditis. METHODS: Four week old male Balb/c mice were inoculated with Coxsackievirus B 3 (CVB 3) intraperitoneally as myocarditis models. Annexin V/PI and flow cytometry were used to detect quantitatively the myocardial cell apoptosis and necrosis. RESULTS: The percentage of myocardial cell apoptosis and necrosis in mice with viral myocarditis was much higher than that in normal controls (P<0.01). Both the percentages of apoptosis and necrosis in myocardial cells were correlated positively with the myocardial histopathological score (r= 0.70 and r= 0.93 , respectively, P<0.01). CONCLUSIONS: There are cell apoptosis and necrosis simultaneously in myocardial cells of viral myocarditis. Both the myocardial cell apoptosis and necrosis are closely correlated with the severity of cardiopathological alterations.

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OBJECTIVE: To investigate the level of exhaled nitric oxide (NO) in children with asthma. METHODS: In 34 asthmatic children (aged 6～14 years) and 36 non respiratory disease subjects, exhaled NO with 13～15 cmH 2O expiratory airway pressure was measured by the chemiluminescent NO analyzer of the online method and the FEV 1 % was measured by a pocket spirometer at the same time. RESULTS: The level of exhaled NO of asthmatic children was significantly higher than that of the non respiratory disease subjects [( 89.4 ± 56.4 ) ppb vs ( 15.8 ± 5.8 ) ppb](P< 0.01 ). There was no significant correlation between exhaled NO and FEV 1% in asthmatic children (r= 0.06 ,P> 0.05 ). CONCLUSIONS: The level of exhaled NO in asthmatic children is higher than that of normal subjects.

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OBJECTIVE: To study the characteristics of bone mineral content (BMC) accretion and the correlation with sex maturity and physical development in adolescents. METHODS: In 161 healthy children aged 9～20 years, the BMC and total alkaline phosphatase (TALP) level were measured using the single photon absorptiometer (SPA) and biochemical methods respectively; the serum levels of bone gla protein (BGP), estrogen and testosterone were determined using RIA; the height and weight were measured routinely and the sex maturity rating was assessed using the Tanner's criteria. RESULTS: The periods of peak height and weight velocity in boys and girls were 11.5 ～13.7 and 9.7 ～11.3 years respectively. The peak BMC accrual occurred in 13.7～16.2 and 11.3 ～13.7 years in boys and girls respectively. BMC accretion in females was earlier compared with males and revealed a significant decline after 16 years of age. The accretion of BMC was highly correlated with the sex maturity rating and there were significant differences in BMC between different pubertal stages (P<0.01). The positive correlations between serum BGP and TALP levels and age were noted (r= 0.59 and r= 0.63 , respectively, both P< 0.01 ). The periods of peak serum BGP and ALP levels and peak height velocity (PHV) were coincident. CONCLUSIONS: There is a close correlation between BMC accretion and sex maturity. There is an asynchrony between BMC accrual and physical development in puberty.

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OBJECTIVE: To study the significance of the micro blood sample for surface antibody of red blood cells (RBC) in the diagnosis of childhood autoimmune hemolytic anemia (AIHA). METHODS: The RBC surface antibody was measured in 145 children with suspected AIHA using the micro blood sample. Of them, 30 cases, besides using the micro blood sample, were measured using the routine method -- the direct Coombs test by taking venous blood of defibrinogen at the same time. RESULTS: Of the 145 patients 13 were diagnosed AIHA by the micro blood sample. The direct Coombs test was positive in the 13 cases. Seven of them had a positive result with univalent antibody IgG, 1 with IgG+C3, 3 with IgG+IgM+C3 and 2 with IgM+C3. In 30 cases with the two tests for the RBC surface antibody, 4 had a positive result with the direct Coombs test. The results of the two methods were consistent. In 26 negative cases, there was a false positive ( 3.85% ) of univalent antibody IgM by the minim finger blood test, and 2 false positive ( 7.69% ) of IgM using the routine method. There was no statistic difference between the two methods (P> 0.05 ). No difference was noted in the protein of supernatant fluid after centrifugation between the two methods (P> 0.05 ). CONCLUSIONS: The micro blood sample for RBC surface antibody in the diagnosis of childhood AIHA is reliable and convenient for re test.

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OBJECTIVE: To study the therapeutic effect of high frequency oscillatory ventilation (HFOV) on respiratory failure in neonates. METHODS: One hundred and eighty six neonates with respiratory failure were treated by HFOV. PaO2, PaCO2 and SaO2 were measured before and after the treatment of HFOV. Of the 186 cases, 143 developed respiratory failure from serious asphxia complicated by the meconium aspiration. Besides PaO2, PaCO2 and SaO2, PaO2/FiO2, a/A PaO2 and oxygenation index were measured in the 143 cases. RESULTS: Eight hours after the treatment of HFOV, compared with the condifion before the treatment, PaO2 and SaO2 increased significantly [( 7.50 ± 1.38 ) kPa vs ( 4.37 ± 0.49 ) kPa and ( 91.22 ± 1.23 )% vs ( 34.70 ± 2.92 ) %, respectively](P< 0.01 ) and PaCO2 decreased significantly [( 4.41 ± 0.37 ) vs ( 9.43 ± 0.51 ) kPa](P< 0.01 ) in 186 cases; the oxygenation index decreased significantly [(16±6) vs (23±7)](P< 0.05 ) and the ratio of P aO 2/F iO 2 and a/A P aO 2 were elevated significantly [(10±5) vs (6±4) and ( 0.12 ± 0.06 ) vs ( 0.07 ± 0.05 ),respectively](P< 0.01 ) in 143 cases. Of the 186 cases, 145 were cured ( 77.96% ), 27 died ( 14.51% ) and 14 were discharged free of treatment. CONCLUSIONS: HFOV is effective on improving pulmonary air exchange in neonates with respiratory failure. It is necessary to use HFOV in infants with meconium aspiration earlier.

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OBJECTIVE: To study the effect of early intervention (enzyme inducer) on bilirubin contents and brainstem auditory evoked potentials (BAEP) in high risk infants. METHODS: Eighty six high risk infants were randomly assigned to the treated group (Group Ⅲ) and untreated group (Group Ⅱ). Thirty seven normal neonates were used as the control group (Group Ⅰ). Group Ⅲ neonates were given phenobarbital and nikethamide at 24 h of birth. The total bilirubin contents were assayed in Group Ⅱ and Group Ⅲ. The BAEP was tested in the 3 groups. RESULTS:  ① The mean total bilirubin content of Group Ⅱ [( 249.0 ± 75.2 ) μmol/L] was much higher than that of Group Ⅲ [( 181.0 ± 54.1 ) μmol/L] at 96 h of birth (t=4.829,P<0.01), and at 144 h the differences were even more significant [( 308.0 ± 93.1 ) μmol/L vs ( 146.0 ± 52.7 ) μmol/L](t=9.985,P< 0.01). ② The incidence rate of abnormal BAEP was 69.1% in Group Ⅱ and 18.2% in Group Ⅲ. There was significant difference between the two groups (χ2= 22.68,P<0.01). CONCLUSIONS: Early intervention using liver enzyme inducer may reduce bilirubin contents and the rate of abnormal BAEP in high risk infants.

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OBJECTIVE: To study the roles of nitric oxide (NO) and oxygen free radical (OFR) in the pathogenesis in children with asthma or Mycoplasma (MP) pneumonia. METHODS: The levels of NO, lipid peroxidation (LPO), thromboxane B 2 (TXB 2) and circulating endothelial cells (CEC) were detected in 36 children with asthma (asthma group), 40 MP pneumonia children (MP group) and 15 normal children (control group). RESULTS: The levels of NO, LPO, TXB 2 and CEC in the acute period in the asthma group [( 162.27 ± 36.12 ) μmol/L,( 8.62 ±0.87 ) nmol/ml,( 229.11 ± 64.75 ) pg/ml and ( 6.13 ± 1.15 ) n/ 0.9 μl , respectively] and in the MP group [( 95.52 ± 33.84 ) μmol/L,( 5.76 ± 0.53 ) nmol/ml,( 388.72 ± 80.09 ) pg/ml and ( 6.36 ± 1.02 ) n/ 0.9 μl , respectively] were significantly higher than those in the control group [( 68.57 ± 13.80 ) μmol/L,( 4.62 ± 1.80 ) nmol/ml,( 105.76 ± 20.10 ) pg/ml and ( 4.40 ± 1.04 ) n/ 0.9 μl , respectively](P< 0.01 ). The levels of NO and LPO in the asthma group were much higher thanthose in the MP group (P< 0.01 ), while the TXB 2 level was higher in the MP group than that in the asthma group(P< 0.01 ). The above 4 index levels decreased both in the asthma and MP groups in the recovery period. Of them, the TXB 2 and LPO levels were lowered to normal, while the NO and CEC levels remained higher ( 82.64 ± 20.56 ) μmol/L and ( 5.41 ± 1.29 ) nmol/L in the asthma group; ( 86.12 ± 21.34 ) μmol/L and ( 5.57 ± 1.12 ) n/ 0.9 μl in the MP group] than those in the control group two weeks later (P< 0.05 or 0.01 ). than those in the control group two weeks later (P< 0.05 or 0.01 ). CONCLUSIONS: Both NO and OFR take part in the pathogenesis of asthma and MP pneumonia. NO and LPO appear to be the sensitive indices for asthma and TXB 2 for MP pneumonia. NO could show the extent of tissue repair after injuries.

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OBJECTIVE: To evaluate the risk factors of relapse in epileptic children after the withdrawal of anticonvulsant therapy. METHODS: The data of 228 children with epilepsy, whose symptoms were controled and anticonvulsant therapy was withdrawn, was studied retrospectively. RESULTS: Fifty One of the 228 patients ( 22.4% ) had a recrudescence of seizures; of these, 47( 92.2% ) had relapse within five years of drug withdrawal. Factors associated with an increased risk of relapse were the age of onset of epilepsy, neurologic dysfunction, frequency of seizure, the duration of remission before withdrawal and the type of seizure (P< 0.05 ). There was no association between the risk factors of recrudescence and the duration of epilepsy before control, age at the discontinuation of therapy, sex and family history of epilepsy. CONCLUSIONS: Patients with the risk factors should be treated and followed up longer than the others. Children who do not have the additional risk factors noted above have an excellent chance of remaining seizure free after the withdrawal of anticonvulsant drugs.

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OBJECTIVE: To study the relationship between emotional disorder and types of temperament in children. METHODS: The temperament types were tested in 48 children with emotional disorder (observed group) and 60 normal children (control group) using the Parent Temperament Questionnaire (PTQ). RESULTS: Type D temperament was found in the majority of the observed group ( 64.6% ); it was 30.0% in the control group (P< 0.01 ). There were more children with type E temperament in the control group (53.3%) than in the observed group (18.7%) (P<0.01). CONCLUSIONS: Children with type D temperament might be more prone to emotional disorder.

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OBJECTIVE: To study the causes, clinical characteristics, diagnosis and treatment of meconium peritonitis (MP) in infants. METHODS: The clinical data of 23 cases of MP was analyzed retrospectively. RESULTS: ①The most common cause of MP was intestinal atresia ( 30.4% ). ②The main clinical characteristics of MP were intraperitoneal calcification, and fibrosis with or without pseudocystformation. ③Surgery was the effective treatment. CONCLUSIONS: Intestinal atresia is the most common cause of MP in infants. Early diagnoisis, proper operative procedures and meticulous postoperative care are the important factors to increase the survival rate of patients with MP.

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OBJECTIVE: To evaluate the method and therapeutic effect of US guided hydrostatic reduction of intussusception in children. METHODS: US was performed in 173 out patient children with suspected intussusception. The 173 cases, diagnosed as intussusception by US (classical US doughnut sign found on US), had US guided hydrostatic reduction. RESULTS: Thirty two cases had difinite US diagnosis of intussusception. The diagnosis was 100% accurate. Of the 32 cases of intusscsception, 30 (93.8%) had successful US guided hydrostatic reduction. Three cases were diagnosed to have ileoileocolic intussusception by US; one of them had successful hydrostatic reduction; and 2 underwent surgery for failed hydrostatic reduction. CONCLUSIONS:US diagnosis of intussusception is reliable and accurate and hydrostatic reduction of childhood intussusception is effective. Though ileoileocolic intussusception can be diagnosed by US, the rate of successful hydrostatic reduction is low.

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