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OBJECTIVE: To detect the contents of L-asparaginase ( L-Asp)-related amino acids in ALL children receiving L-Asp treatment; and to study the relationship between changes in L-Asp contents and clinical efficacy on .ALL. METHODS: Plasma concentrations of asparagine (Asn), aspartic acid (Aspa), glutamine (Gln) and glutamic acid (Glu) in different stages of L-Asp treatment were measured by the HPLC-FLD method in 20 children with ALL (17 cases of B-ALL and 3 of T-ALL). RESULTS: The plasma Asn level after the 1st administration of L-Asp decreased significantly. With the administration of L-Asp according to the induction remission formula of A11-XH99, the Asn level remained low, even to nil level. This status remained for 7 days after cessation of L-Asp, and even 10 days in 15 cases of B-ALL, but the Asn level in all the cases of T-ALL and only 2 cases of B-ALL increased and even returned to nomal 7 days after L-Asp treatment ended. The concentration of Glu after the second and the last administrations of L-Asp increased significantly and it returned to normal on the 7th day after cessation of L-Asp, while the concentration of Aspa increased and failed to return to normal on day 10 after cessation of of L-Asp. The concentration of Gln slightly decreased during the course of treatment with L-Asp, but the difference was not significant compared with that before treatment.CONCLUSIONS: The Asn level of children with T-ALL after cessation of L-Asp recovers earier than that of children with B-ALL, indicating that it may be helpful for individualization of L-Asp administration in the treatment of ALL on the basis of the immunophenotype of children. The glutaminase activity of L-Asp does not exert effects on the treatment.

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OBJECTIVE: To study the mRNA expression of growth associated protein-43 (GAP-43) in neonatal rats with hypoxic-ischemic brain damage (HIBD) and the influence of basic fibroblast growth factor (bFGF) on GAP-43 mRNA. METHODS: Twenty normal Wistar rats were used as the normal group, and another 54 7-day-old Wistar rats were randomly assigned into the sham operation group, HIBD group and bFGF treatment group. Immediately after HIBD models were made, 4 U/g of bFGF was injected each day in the treated group, and in the HIBD group an equal amount of NS was injected ip each day. The expression of GAP-43 was examined by RT-PCR in the three groups on day 1, day 3 and day 7 after HIBD. And the expression of GAP-43 in the normal group on the 2nd, 5th, 7th and 14th days after birth was also examined. RESULTS: The expression of GAP-43 mRNA on the 2nd day after birth was lower and it increased later to a peak on the 7th day in the normal rats. Compared with the sham operation group, GAP-43 mRNA expression on both sides of the brain in the HIBD group decreased rapidly on the 1st day after damage. In the bFGF treatment group, GAP-43 mRNA expression on the 3rd day after damage increased markedly compared with that in the HIBD group of the same age and that in the 8-day old treatment group, and it still remained at high level on day 7 after damage. CONCLUSIONS: The expression of GAP-43 mRNA in the brain of neonatal rats may change with age. It is related to the development and maturation of the brain. bFGF may have some positive effects on the restoration of brain function after HIBD.

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OBJECTIVE: To study the influence of nitric oxide (NO) in rats with anemia in chronic disease (ACD) and the effect of NO on the expression of transferrin receptor (TfR) in bone marrows and to provide experimental evidence for the prevention and treatment of ACD. METHODS: The conventional animal model of rheumatoid arthritic (RA) was established by injection of Freund's complete adjuvant. On the basis of this model, we injected Freund's complete adjuvant repeatedly to establish the ACD model. The rats were randomly assigned into three groups (Group A: control group; Group B: inflammatory group; Group C: inflammatory + NO inhibitory agent group). The histopathological changes of the toe joints of the rats were observed and the contents of NO, Hb and nitric oxide synthetase (NOS), and the expression of TfR were measured in the three groups. RESULTS: In Group B, the contents of NO and NOS in the serum were higher than those in Group A; TfR expression in bone marrow cells was lower than that in Group A, and anemia was more severe than that in Group A. After administrating NOS inhibitory agent (L-NAME), anemia was improved; the contents of NO and NOS remarkably decreased compared with those in Group B, but were still higher than those in Group A; TfR in bone marrow cells obviously increased compared with that in Group B, but was still lower than that in Group A. CONCLUSIONS: NO may play an important role in the pathogenesis of ACD and regulation of TfR on ACD, thereby providing experimental evidence for further study of the pathogenesis of ACD. It is helpful in hindering the development of anemia by reducing the NO level as early as possible, and is a new way of treating ACD.

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OBJECTIVE: To study the deleterious effect of prolonged hyperoxia exposure on preterm rat lungs. METHODS: On the 2nd postnatal day, preterm SD rats were randomly assigned to the air group (I) and hyperoxia group (II, exposed to 85% O2). After 3, 7 and 14 days of exposure, the contents of total protein (TP), hydroxyproline (HYP) and malondialdehyde (MDA), total cell counts and differentiation in bronchoalveolar lavage fluid (BALF), ratio of lung wet weight/dry weight (W/D), and lung collagen content were examined. After 3, 7, 14 and 21 days of exposure, lung histopathology and radial alveolar counts (RAC) were performed. RESULTS: On day 3 of hyperoxia exposure, only the MDA content increased in Group II(P<0.05). On day 7 and 14, TP, HYP, total cell counts, the percentage of neutrophils in BALF and lung W/D also significantly increased ( P < 0.05 or 0.01). The differences of lung collagen contents between the two groups were not significant ( P >0.05). Hyperoxia exposure resulted in subacute alveolitis and inhibition of lung development on day 7, 14 and 21. RAC was similar between the two groups on day 3 (4.9±0.7 vs 5.0 ±0.8), but different on day 7 (5. 9 ± 0.9 vs 7.1 ± 0. 9; P <0.05. On day 14 and 21, RAC decreased more obviously in Group II compared with that in Group I (7.0±0.8vs9.9±0.6, 7.3 ± 0.9vs10.5±0.8; P <0.01). CONCLUSIONS: Prolonged exposure to 85% O2 may result in subacute inflammatory lung injury and inhibition of lung development in preterm rats.

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OBJECTIVE: To explore the effect of glycine on serum levels of IL-1 and IL-6 in rats with necrotizing enterocolitis (NEC) induced by endotoxin and hypoxia. METHODS: Forty SD rats were randomly assigned into the glycine-treated group and the normal saline (NS) control group. In the glycine-treated group, glycine (1 g/kg) was injected intravenously and lipopolysaccharide (LPS) of 2 mg/kg was administrated five minutes later. The control group rats were treated with the same volume of NS as a substitute for glycine. In both groups, 90 minutes after injection of LPS, FiO2 given was reduced from 21% to 5% and ventilation continued for 180 min or until the death of rats. At the end of the experiment, the blood samples and sections of the intestine were obtained immediately. Serum levels of IL-1 and IL-6 were measured using ELISA. The histopathological changes of the small intestine were studied. RESULTS: The survival time of the glycine-treated group was significantly longer than that of the control group [(159.25 ±22.78) min vs (138.75 ± 19.05) min] ( P < 0.01). The injury of the small intestine in the glycine-treated group was markedly alleviated ( P <0.01). The levels of IL-land IL-6 in the glycine-treated group were significantly lower than those in the control group [(149.1 ±76.1) ng/L vs (472.1 ± 505.6) ng/L, (204.8 ± 163.5) ng/L vs (585.8 ± 574.5) ng/L, respectively] ( P <0.01). CONCLUSIONS: Glycine could reduce the levels of IL-1 and IL-6 and alleviate injuries of the intestine in rats with NEC induced by LPS and hypoxia.

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OBJECTIVE: To compare the therapeutic effect and complications of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) in neonates with the respiratory distress syndrome (RDS). METHODS: Meta analysis was used to evaluate the data extracted from 12 published papers. Combined Odds ratio (OR) and its 95% confidence interval were calculated. RESULTS: Compared to CMV, HFOV was found to improve pulmonary function ( P <0.05) and reduce the incidence of chronic lung disease (CLD) ( P <0.01). However, the use of HFOV resulted in an increase in intracranial hemorrhage (ICH) ( P <0.05) in infants with RDS. There was no difference in the incidence of air leak induced by HFOV and CMV. CONCLUSIONS: HFOV is more beneficial than CMV in its therapeutic effect on neonatal RDS and in its ability to reduce the incidence of CLD. This benefit may be offset by the increase in the occurrence of ICH when using this modality.

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OBJECTIVE: To study the dose-effect and time-effect of heat shock protein-70 (HSP70) expression induced by curcumin, an antioxidant compound extracted from the spice tumeric, and the protective effect of curcumin on infectious brain edema in rats. METHODS: Dose-effect and time-effect: 24 SD rats were randomly assigned into four groups: control group, dimethyl sulfaxide (DMSO) group, heat shock group and curcumin group. The rats in the curcumin group were subdivided into groups receiving 80, 40, 20 and 10 mg of curcumin, respectively. Another 24 SD rats injected with 40 mg curcumin were divided into groups sacrificed at 0 h, 2 h, 4 h, 6 h, 12 h, 16 h, 24 h, and 48 h. HSP70 expression was detected by the Western blotting analysis. Protective effect of curcumin on infectious brain edema: 52 SD rats were assigned into five groups: normal control group, infectious brain edema group, DMSO pretreatmentgroup (DMSO group), heat shock pretreatment group (HS group), and curcumin pretreatment group (CUR group). Water content and Na+ and K+ contents in brain tissues were measured. RESULTS: Compared with the control group, HSP70 expressions of the heat shock group, 40 mg curcumin group and 80 mg curcumin group significantly increased, especially in the 40 mg group ( P <0.01). HSP70 expression gradually increased with the time after the injection of curcumin, peaking at 16 h and reaching a plateau at 24 h and 48 h. The contents of water and Na+ in brain tissues significantly decreased in the HS and CUR groups compared with the un-treated infectious brain edema group. CONCLUSIONS: HSP70 expression can be induced by pretreatment with curcumin, and there are dose-effects and time-effects. The protective effect of curcumin against infectious brain edema may be a consequence of increased HSP70 expression in rats.

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OBJECTIVE: To develop an improved neonatal piglet model of hypoxic ischemic brain damage (HIBD). METHODS: Fourteen 7-day-old piglets were subjected to temporary occlusion of both carotid arteries, followed by mechanical ventilation with low concentration of oxygen ( FiO2 = 0.06) for 30 minutes. Before and after the interventions, the heart rate, temperature, invasive blood pressure, blood gas, and concentrations of blood glucose and lactose were measured, electroencephalogram (EEG) was monitored, and neural behavior scores and pathologic changes of brain tissues were evaluated. RRESULTS: Compared with the pre-intervention status, blood glucose and lactose concentrations significantly increased and the heart rate, mean arterial pressure, PaO2 and basic excess significantly decreased after the hypoxic-ischemic intervention. In addition, the frequency and voltage of EEG decreased 30 min after the intervention. The neural behavior scores were significantly lower at 24 h and 72 h after the intervention. The pathologic scores of the cortex, hippocampus and basal were 2.4 ± 0.6 and 2.0±0.4, 2.0± 0.7, respectively. CONCLUSIONS: We have developed a reliable and reproducible piglet model of HIBD.

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OBJECTIVE: To study whether Panax Notoginseng Saponins (PNS) has a protective effect on brain cells in neonates with hypoxic-ischemic encephalopathy (HIE). METHODS: Forty-two neonates with HIE were randomly assigned into the treatment group (n = 24) and the control group (n = 18). Ten normal neonates served as a reference group In addition to conventional therapy, the treatment group received PNS, 12-15 mg/kg daily for 5-8 days. Concentrations of intra-erythrocytic free calcium (RBC [Ca2+ ]i) in the three groups were assayed by a new staining calcium agent Indo-1/Am at the time of admission (before the treatment), and 48 hours and 72 hours after the treatment. RESULTS: Before the treatment, RBC [Ca2+ ]i concentrations in the HIE treatment group and control group were significantly higher than that of the normal non-HIE reference group ( P < 0.01); and there was no obvious difference between the two HIE groups. RBC [Ca ]i concentration in the PNS group obviously decreased at 48 hours and 72 hours after the PNS treatment compared with the control HIE group ( P <0.01). A significant difference was found in the RBC [Ca2+ ]i concentration in the; PNS group before and after the PNS treatment for 72 hours [(2.619 ± 0.175) vs (2.358 ±0.280); P <0.01]. PNS treatment significatly reduced central respiratory failure (20% vs 100%), circulatory dysfunction (33.3% vs 83.3%) and gastrointestinal symptoms (16.7% vs 91.7%) compared to the non-treated HIE group. CONCLUSIONS:Treatment with PNS improves the clinical symptoms in neonates with HIE. The mechanism of this neuro-protective effect may involve the reduction of intra-ery throcyte free calcium overload.

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OBJECTIVE: To study the characteristics of hospital infection in the pediatric department and neonatal unit in order to provide reference data for hospital infection control. METHODS: Data on nosocomial infections of the patients hospitalized in pediatric wards and neonatal units of the .obstetrical departments in 135 general hospitals participating in the National Monitoring Network of Hospital Infection were collected. Monitoring results were reported monthly according to uniform requirements. RESULTS: Of the 155 975 person- times monitored from January to December in 2000, 4 310 (2.8%) and 4 699 person - times (2.5% ) respectively had hospital - acquired infections in the pediatric wards and neonatal units of the obstetrical wards. The incidence of nosocomial infections in neonates hospitalized in the pediatric wards (4.1%) was significantly higher compared with non - neonates hospitalized in the pediatric wards (2.5%) and with neonates hospitalized in the neonatal units of the obstetrical wards (3.2%) (P<0.01). Hospital infections occurred mainly in the respiratory tract and skin soft - tissues. CONCLUSIONS: There is a high incidence of hospital infections in sick neonates. To reduce the incidence of hospital infections, it is important to emphasize monitoring and take effective measures, including prevention of respiratory infection and skin infection by strict isolation and aseptic manipulation.

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OBJECTIVE: To study the effect of erythromycin on airway inflammation in asthmatic guinea pigs. METHODS: A model of allergic asthma was developed by sensitizing guinea pigs with ovalbumin. Twenty - four hours after the induction of asthma, cells in bronchoalveolar lavage fluid (BALF) were categorized, the right lung was processed for histopathological examination and the numbers of eosinophils, neuthrophils and monocytes in the BALF and bronchial lumen were counted. Eight normal guinea pigs were used as the controls. RESULTS: The numbers of eosinophils, neuthrophils and monocytes in the BALF [(10.9 ± 1.2), (3.9 ± 0.7) and (4.2 ± 1.0) × 108/L, respectively] and bronchial lumen [(73.6 ±8. 8), (7.1 ± 1.9) and (3.5 ± 0.7) high powered field (HP), respectively] of the asthma group were significantly higher compared to those in the BALF [(0.5 ±0.1), (0.4±0.1) and (2.0 ± 0.4) × 108/L, respectively] and bronchial lumen [(5.5 ±1.6), (1.2 ± 0.9) and (0.7±0.5)/HP, respectively] of the controls ( P< 0.01 or 0.05). After pretreatment with erythromycin, eosinophils neutrophils, and monocytes in the BALF [(3.3 ± 0.5), (1.710.2) and (3.1 ±0.7) × 108/L, respectively] and bronchial lumen [(38.7 ± 5.6), (3.7±0.8) and (2.2 ±1.0)/HP, respectively] of the asthma group decreased significantly ( P <0.01 or 0.05), but remained higher than those of the controls. CONCLUSIONS: Erythromycin alleviates but does not block completely airway inflammatory reactivity.

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OBJECTIVE: To study the relationship between obesity and the serial blood pressure measurements in children. METHODS: Two hundred and thirty-five Grade One pupils from Hefei City were included in the study and vital signs (blood pressure, height, weight, heart rate, etc. ) were measured once a year. A 4-year follow- up for them was performed to study the changes of blood pressure. RESULTS: Blood pressure gradually increased over time. A significantly positive correlation was found between the initial blood pressure and successive blood pressure values obtained during the follow-up. Correlation coefficients of systolic blood pressure and diastolic blood pressure in year 1,2,3 and 4 in turn were 0.1724, 0.5173, 0.2024, 0.5779 and 0.4347, 0.3327, 0.1669, 0.1481, respectively. There was a stronger correlation if the time between measurements was shorter. There was significant difference in the blood pressure level between obese and non-obese children. CONCLUSIONS: Obesity is associated with higher blood pressure. High blood pressure and/or obesity in childhood may be risk factors in the development of essential hypertension in adults.

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OBJECTIVE: To study the risk factors associated with infection by extended-spectrum β-lactamase-producing (ESBLs) bacteria in children. METHODS:Clinical data of 29 cases of infection by positive-ESBLs bacteria was studied retrospectively. Eighty-nine cases of negative-ESBLs bacteria served as the controls. Non-conditional logistic regression analysis was used to analyze potential risk factors. RESULTS: Multiple-factors non-conditional logistic regression analysis showed that age, combined application of antibiotics, intubation, use of immuno-suppressive drugs and the times of hospitalization in the three months preceding the infection were the independent risk factors for infection by positive-ESBLs bacteria. CONCLUSIONS: Risk for infection by positive-ESBLs bacteria is multifactorial. It is important to reasonably use antibiotics and immuno-suppressive drugs, reduce invasive intubation, and stress the asepsis principle so as to decrease the incidence of infection by positive-ESBLs bacteria.

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OBJECTIVE: To study the relationship between anticardiolipin antibodies (ACA) and vascular injury in children with Kawasaki disease (KD). METHODS: Serum ACA-IgG, IgM and IgA were measured qualitatively using ELISA in 55 children with KD. Thirty healthy children served as the controls. RESULTS: In the children with KD, serum ACA-IgG and IgM were found to be positive in 56.4% (31/55) and 23.6% (13/55), respectively. No ACA antibodies were found in the controls ( P <0.01). Severity of clinical manifestations in the children with KD positive or negative for ACA-IgG did not differ. Of the 6 children with KD complicated by coronary thrombus, there were 5 cases of positive ACA-IgG. CONCLUSIONS: ACA-IgG, the most common antibody in children with KD, is correlated to vascular injury, but is not useful in evaluating the severity of KD.

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