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OBJECTIVE:  To study the isolation and cultiv ation of neural stem cells in neonatal rats. METHODS: Cell culture, indirect immunofluo rescence cytochemistry and gene transfection techniques were used. RESULTS: The neural stem cells isolated in newborn rats had the potential to form clones, express neuroepithelial stem cell protein(nestin) and differentiate into mature neurons and astrocytes. Moreover, green fluorescent protein vector could be efficiently transfected into this cell line. CONCLUSIONS:  Neural stems cells can only be characterized on a critical functional basis in terms of their undifferentiated features, capacity of self-renewal, proliferation and pluripotentiality, and can express ex vivo gene efficiently.

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OBJECTIVE: To investigate the effects of basic fibroblast growth factor(bFGF) on neurons following hypoxic-ischemic brain damage(HIBD) in neonatal rats. METHODS: Seven-day-old Wistar rats were randomly assigned into a sham operation group, an HIBD group, and 2 bFGF-treated(10 μg/kg and 17.5 μg/k g) HIBD groups(n=8 for each group). The HIBD model using the carotid ligation were previously established. In the bFGF groups, the rats received bFGF by intrapritoneal injection for 7 days. The rats in the untreated HIBD group were injected with normal saline(NS) intraperitoneally at the same time as the bFGF groups. Micro-morphological features and activities of acetylcholinesterase(AchE) and acid phosphatase(ACP) in the HIBD rats treated with bFGF were compared with those in the untreated HIBD rats. RESULTS: Two weeks after HI, the brain ipsilateral to the carotid ligation was severely injured, having selective neuronal cell death, gliosis in the striatum and cortex of the untreated HIBD group; these findings were reduced in the bFGF-treated groups. AchE activity in the damaged neurons of the striatum and cortex obviously decreased in the HIBD group, but was nevertheless higher in the bFGF-treated groups than in the untreated animals. ACP activity in the injured neurons of the ipsilater al striatum increased markedly, but the increase in ACP activity was less in the bFGF groups than in the untreated HIBD group. There were no significant differences in the outcome between the two bFGF dosages.CONCLUSIONS: bFGF may promote the recovery of enzyme activities and the micro-morphological structure of neurons in the striatum and cortex following HI.

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OBJECTIVE: To study the clinical safety and neurop rotection of selective brain hypothermia for full-term neonates with hypoxic-i sch emic brain damage(HIBD) following perinatal asphyxia. METHODS: Twenty-two severe asyxiated neonates were randomly assigned into the treatment group(n=11) a nd the control group(n=11). Besides the routine treatment, brain hypothermia was us ed in the treatment group and their nasopharyngeal temperature was maintained a t(34.0±0.2)℃for 72 hours. The control group neonates received routine treatment. Neuron-specific enolase(NSE) in the cerebrospinal fluid(CSF), serum CK - MB a nd urine β2-microglobulin(β2-MG) were measured in the two groups between 6 4 and 72 hours after the treatment. EEG was recorded at 6 hours, 10 days and 3 months af ter birth. Neurodevelopmental assessment was done with neonatal behavioral neurological assessment(NBNA) at 10 and 28 days of life and with CDCC at 3 months after birth. RESULTS: NSE in the control group was higher than that in the tre atment group [(24.6±5.3) μg/L vs(19.5±2.2)μg/L](P < 0.01). NBNA of t he treatment group(36±3) sh owed improvement at 28 days after birth compared with that in the control group (32±2)(P < 0.01). In the treatment group, EEG normalized at 10 days and 3 months after birth respectively. However,EEG of 2 patients in the control group remai n ed abnormal. Serum CK-MB and urine β2-MG were elevated in the 2 groups, but no significant difference was noted.CONCLUSIONS: Selective brain hypothermia may be useful and safe for neuroprotection in full-term neonates with HIBD following perinatal asphyxia .

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OBJECTIVE: To investigate the risk factors for hospital acquired pneumonia(HAP) in children with the nephrotic syndrome(NS).METHODS: Clinical data of 198 children with NS admitted between December,1997 and December, 2000 were analyzed retrospectively. RESULTS: Of the 198 cases, 63 had nosocomial infection(31.8%), including 33 cases of HAP(52.3%), accounting for the largest percentage of nosocomial infection. There was no difference between the HAP children and non-infection children with respect to age, course of disease, sex, clinical type of NS, leucocyte count, serum IgA, IgM ,and BUN levels, and 24 h urine protein quantity. Duration of hospitalization before acquiring nosocomial infection was longer [(44.6±7.6) days vs((23.9±9.3)days, the percentage of patients with severe edema(51.5% vs 26.8%) and immunosuppressive agent administration was higher(45.5% vs 19.1%), and the serum albumin and IgG levels were lower [(11.46±3.37) g/L vs(22.91±8.67) g/L and(2.72±1.32) g/L vs(6.81±1.89)g/L ,respectively] in HAP children copmpared to those non infection children(all P < 0.05). CONCLUSIONS: Severe edema, reduced levels of serum albumin and IgG, use of immunosuppressive agent, a nd longer hospitalization duration may be risk factors for HAP in childre n with NS.

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OBJECTIVE: To study the characteristics of endotracheal pathogens in children with ventilator-associated pneumonia(VAP) in order to establish more e ffective treatment and prophylaxis regimens. METHODS: Endotr acheal tube secretion s were collected for bacterial and/ fungal culture and drug-sensitivity testing in 34 children with VAP. RESULTS: There were 106 bacterial strains cultured from the 34 patients. Seventy-two(67.9%) cultures yielded Gram-negative bacteria, of wh ic h 17 were Acinetobacter baumanii, 20 Pseudomonas aeruginosa, 17 Klebsiella pneum oniae, 6 Enterobacteriaceae, 4 Stenotrophomonas maltophilia and 8 Escherichia coli. There were 6(5.7%) Gram-positive cocci, including 5 type A Streptococcus a n d 1 Staphylococcus aureus. Twenty-eight cultures were positive for fungi. Sixte e n patients had mixed infections. Eighty percent of the Enterobacteriaceae and 50 % of the Acinetobacter baumanii were resistant to third generation cephalosporin s and aminoglycosides; 88.9% of the Stenotrophomonas maltophilia were resistant to imipenem, and 83.3% of the Gram-positive cocci to penicillin. CONCLUSIONS: Gra m-negative bacteria account for the majority of pathogens in children with VAP.Fungal infections should not be disregarded. Antibiotics should be appropriately used according to drug-sensitivity testing.

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OBJECTIVE: To explore the differences in adaptive behaviours between epileptic children and nonepileptic children. METHODS: Adaptive behaviours were studied in 42 children with epilepsy and 42 healthy children(control group), aged between 3 and 12 years. RESULTS: ①Adaptive Quotient(ADQ) in the epileptic children was obviously lower than that in the control group [(82.9±27.3) vs(103.0±14.6)](P < 0.05 ). The defects of adaptive behaviours in children with epilepsy were found in language develop ment, social responsibility and time*.spatial orientation. Significant differences were found in the independent factor [(70.0±14.4) vs(79.3±11.8);P < 0.05] and cognitive factor [(24.4±11.9) vs(35.7±8.3);P < 0.01] between the epileptic children and controls . The significant risk factors associated with the defects of adaptive behaviours in the epileptic children were the state of epilepsy, family relation, edu cational status of the parents, and social surroundings. CONCLUSIONS: Epileptic childr en are more prone to defects in adaptive behaviours. Psychological interv entions may improve the life quality of epileptic children.

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OBJECTIVE: To explore the determination of tumor necrosis factor-α(TNF-α) in the systemic inflammatory response syndrome(SIRS) caused by pneumonia in children. METHODS: Fifty-one children with pneumonia were divided into the SIRS group(n=36) and non-SIRS group(n=15) according to the entry criteria of childh ood SIRS. The SIRS group was subdivided into the S1 group(n=28) and S2 grou p(n=8) according to disease severity criteria(S1 having 2 SIRS entry criteria items and S2 having 3 items). TNF-α levels were then determined in each group.RESULTS: On day 1, the TNF-α level in the SIRS group [(26.05±18.27)ng/L] was higher than that in the non-SIRS group [(9.54±4.33)ng/L](P<0.05). On days 1, 3 and 5 of ho spitalization, the TNF-α level of the S2 group was higher than that of S1 group [(39.38±21.91) ng/L vs(22.24±15.51) ng/L,(41.63±20.22) ng/L vs(26.22±18.79)ng/L and(45.58±17.19)ng/L vs(23.21±15.91)ng/L, respectively; all P < 0.05]; m oreover it appeared to elevate constantly. CONCLUSIONS: TNF-α may be of value in assessing the degree of severity and prognosis of SIRS caused by pneumonia.

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OBJECTIVE: To study the clinical significance of simultaneous determination serum contents of C-reactive protein(CRP) and sialic acid(SA) in the diagnosis and treatment of neonatal bacterial infection. METHODS: Serum levels of CRP and SA were simultaneously determined in the same sample in 52 neonates(ranging from day 1 to 1 week of life) with bacterial inf ection. RESULTS: The serum CRP level [(68.3±32.8)mg/L] significantly increased within 24 hours of infection compared with that in the non-i nfection neonates [(0.78±0.25)mg/L](P < 0.01).When the infection was pa rtially or completely controlled the serum CRP level decreased significantly(P< 0.01). The serum SA content within 24 hours of infection was increased, but it w as not s ignificantly different from that in the normal cases [(0.91±0.40)mmol/L]. It was gradually elevated and became significant at day 1～3 and day 4～7 of infection [(1.88±0.85) and(2.95±0.87)mmol/L,respectively](P < 0.01).Only when the infection was completely controlled did the serum SA content in infection neonates reduce to normal. CONCLUSIONS: The combined assay of serum CRP and SA contents is helpful in making an earlier diagnosis and proper treatme nt for neonatal bacterial infection.

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OBJECTIVE: To evaluate the diagnostic va lue of serum neuron specific enolase(NSE) and single photo emission computed tomography(SPECT) regional cerebral blood flow(rCBF) imaging in childhood status epilepticus(SE). METHODS: Serum NSE concentration was assayed in 28 children with SE and in 40 normal controls using E LISA. SPECT rCBF imaging was performed in 15 cases of SE. RESULTS: The mean serum NSE concentration in the SE patients [(15.13± 6.22) μg/L] was higher than that in normal cont rols [(2.64± 0.77) μg/L] on day 1(P < 0.01). However,it gradually reduced from day 3 and normalized on da y 7. SPECT rCBF imaging was abnormal in 11 of the 15 SE cases.CONCLUSIONS: Serum NSE is a marker in the diagnosis of brain injury in children with SE. SPECT rCBF imaging may be useful in assessing the location of brain injury in children with SE.

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OBJECTIVE: To study the relationship between α-smooth muscle actin(α-SMA) and clinical symptoms(hypertension and hyperlipoproteinemia ) in children with mesangial proliferative glomerulonephritis(MsPGN). METHODS: Expression of α-SMA was detected using immunohistochemistry and computer image evaluation in 33 children with MsPGN. RESULTS: The expression of α-SMA was higher in MsPGN children with hypertension and/or hyperlipoproteinemia than that in MsPGN children without hypertension and/or hyperlipoproteinemia(P < 0.05). CONCLUSIONS: Expression of α-SMA by mesangial cells appears to be activated by hypertension and hyperlipoproteinemia in children with MsPGN.

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OBJECTIVE: To study the effect of dexamethasone(DXM) on the cellular DNA synthesis and airway remodelling of airway in asthmatic rats. METHODS: Asthmatic model was established using SD rats. The changes of the airway wall were observed by coll agen and mucus staining and Bromodeoxyuridine(Brdu)-positive cells were detecte d using immunohistochemical technique in the airway smooth muscle(ASM) and epit heli um in the asthmatic model rats(model group), DXM inhalation rats(DXM group), a nd normal rats(control group). RESULTS: ① The collagen d eposition in the subepithelium and mucus staining in the airway obviously decreased in the DXM group compared with the model group.②The Brdu-positive cells of ASM in the model group(10.25±2.09) were significantly higher than those in the control group(7.15±2.05) and the DXM group(6.85±2.20)(P<0.01). The Brdu-positive cells of the epithelium in the model group(21.83±7.01) were also significantly higher than those in the control group(16.22±4.36) and the DXM group(16.92±3.48)(P<0. 05). CONCLUSIONS: Inhaling DXM may alleviate airway inflammation response, inhib it DNA synthesis of airway cells and prevent from developing airway remodelling in asthmatic rats.

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OBJECTIVE: To study the relationship between the incidence and mortalit y of the multiple organ dysfunction syndrome(MODS) following asphyxia and the seve rity of asphyxia, pregnant age and birth weight in neonates. METHODS: A prospective study was done in 100 neonates with asphyxia. RESULTS: The incidence of MODS in the severe asphyxia neonates(severe group)(71.4%) was much higher than that in the mild asphyxia neonates(mild group)(30.8%)(P < 0.01); th e incidence of brai n, lung , cardiovascular system, kidney and gastroenteric damage in the severe group was 91.4 %,77.1 %, 54.3 %, 34.3 % and 22.9 % ,respectively. It differed signi ficantly fro m that in the mild group(38.5%, 33.8%, 20.0%,12.3% and 7.7%,respectively) (P <0.01 or 0.05).Ho wever, there was no significant difference in the incidence of liver damage bet ween the two groups.The mortality in the severe group(22.9%) wa s much highe r than that in the mild group(6.2%)(P < 0.05).There was a close correlat ion bet ween the incidence and mortality of MODS and the pregnant age and birth weight; the incidence and mortality of MODS in premature neonates and low birth weight neonates were higher than those in full?term neonates and normal birth weight ne onates(P < 0.05). CONCLUSIONS: The key issue of reducing the incidence of MOD S following asphyxia is to improve perinatal care and reduce the incidence of pr eterm birt h and low birth weight neonates. It is also necessary to take measur es to prevent asphyxia in neonates.

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