Reliability and validity of prognostic indicators for Guillain-Barré syndrome in children.

AIM: To explore the clinical characteristics and prognostic predictors of Guillain-Barré syndrome (GBS) in Chinese paediatric patients. METHOD: The clinical features of children with GBS hospitalized in the Children's Hospital of Chongqing Medical University were summarized retrospectively. The correlation between the Erasmus GBS Outcome Score (EGOS)/modified Erasmus GBS Outcome Score (mEGOS), GBS disability score (GDS)/modified Rankin Scale (MRS), Erasmus GBS Respiratory Insufficiency Score (EGRIS), and mechanical ventilation were evaluated. RESULTS: One hundred forty-two patients (86 males, 56 females; median 62.50 months [interquartile range 41.00-97.50]) with classic GBS were enrolled in the study. In the present GBS cohort, 134 (94.37%) patients could walk independently (GDS ≤2) and 121 (85.21%) could manage without assistance (MRS ≤2) at 6 months. Eighteen (12.68%) patients with GBS required mechanical ventilation. The performance of mEGOS on admission, mEGOS on day 7, and EGOS-predicted GDS outcome at 4 weeks, 3 months, and 6 months in the paediatric patients with GBS admitted within 2 weeks of disease onset and that of the MRS outcome were evaluated. The EGRIS in individuals who required mechanical ventilation was significantly higher than in patients without mechanical ventilation (median = 6 vs median = 3, p < 0.001). INTERPRETATION: In Chinese paediatric patients with GBS who were admitted 2 weeks after disease onset, the mEGOS and EGOS are validated indicators for the prediction of clinical outcomes 6 months after onset. EGRIS is helpful in predicting the implementation of mechanical ventilation in the acute phase. WHAT THIS PAPER ADDS: The Erasmus Guillain-Barré syndrome (GBS) Outcome Score (EGOS) and modified EGOS are reliable prognostic predictors in paediatric patients with GBS. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) is an effective predictor of mechanical ventilation in paediatric patients with GBS. An EGRIS of ≥5 indicates a high risk of mechanical ventilation in the acute phase.

Characteristic Analysis of Imprinting Template of Flavonoid Clusters in Four Chinese Medicines to Lung Meridian and Establishment of Experimental Approach of Meridian Tropism in Vitro / 中国实验方剂学杂志

ObjectiveTo study the characteristics of imprinting template of flavonoid clusters in four Chinese medicines attributed to the lung meridian， and to establish an in vitro experimental approach for the study of the attribution of Chinese medicines to the lung meridian. MethodBased on 13 Chinese medicines， including Xanthii Fructus， Houttuyniae Herba， Fagopyri Dibotryis Rhizoma， Belamcandae Rhizoma and so on， which only belong to the lung meridian in Chinese Materia Medica（the 13th Five-Year planning textbook of general higher education）， we identified four representative Chinese medicines， namely Houttuyniae Herba， Fagopyri Dibotryis Rhizoma， Belamcandae Rhizoma and Mori Cortex， and set up their fingerprints by high performance liquid chromatography（HPLC） and calculated the molecular connectivity indices of various components in the four Chinese medicines， the similarity to their mean value was calculated by included angle cosine method， so as to establish the quantitative relationship of construction versus imprinting ability， and to determine the order of each component in the lung meridian. A total of 7 reference substances， including chlorogenic acid， rutin， quercetin， isoquercitrin， hyperoside， epicatechin， and iridin， were selected to validate the overall conformational relationships of flavonoids of the model， as well as its predictive ability. ResultHouttuyniae Herba， Fagopyri Dibotryis Rhizoma， Belamcandae Rhizoma and Mori Cortex contained a total of 437 chemical components with an average molecular connectivity index similarity of 0.995 6. The four Chinese medicines contained a total of 204 flavonoids with an average molecular connectivity index similarity of 0.978 0， which was second only to the alkaloids with 0.985 1. The retention time（tR） of the 7 reference substances showed a good conformational relationship with the similarity of the molecular connectivity index（tR=831.4×S-790.3， r=0.861 4， P<0.01）， which was applicable to the in vitro attribution study of the position， similarity， and relative similarity with tR of the cluster of 98.04% of flavonoids. Accordingly， the 1st position was kuwanon D， with a similarity of molecular connectivity index of 0.987 7 and a tR of 30.88 min， the 200th position was chlorogenic acid， with a similarity of molecular connectivity index of 0.958 2 and a tR of 6.36 min. The total first-order moment of the four Chinese medicines calculated by total statistical moment method of fingerprint was 24.26 min， ranked 21， which could characterize 99.19% of the whole， and the total first-order moment of the total peak area of the 7 reference substances in the four Chinese medicines was 20.00 min， with a rank of 46， which could characterize 98.68% of the whole. ConclusionFlavonoid clusters are suitable probes for the characterization of imprinting template for the study of the lung meridian， which can be established a quantitative imprinting method for meridian tropism of Chinese medicines in vitro.

A Cohort Study of Invigorating Qi and Dissipating Depression Herbs on Depressive Disorders in the Clinical Efficacy / 世界科学技术-中医药现代化

Objective To evaluate the dynamic efficacy of Invigorating Qi and Dissipating Depression Herbs in the treatment of depressive disorders and its effect on recurrence rate and suicidal thoughts.Methods The prospective cohort study was used to divide the patients into three cohorts according to the different exposure factors(treatment regimens):Western medicine group,integrated traditional Chinese and Western medicine group,and Invigorating Qi and Dissipating Depression Herbs group,and followed up for 2 years,and the treatment effects of each cohort at half a year,one year,one and a half years,and two years were observed respectively,and the evaluation indicators were Montgomery Depression Scale(MADRS),Hamilton Anxiety Scale(HAMA)and Social Deficit Screening Scale(SDSS)reduction rates,and endpoint events(relapse,suicidal ideation)incidence;By comparing the efficacy and endpoint event rate of the three cohorts,the effect of Invigorating Qi and Dissipating Depression Herbs on improving depressive disorders was evaluated.Results A total of 409 patients(67 in the Western medicine group,131 in the integrated traditional Chinese and Western medicine group,and 211 cases in the Invigorating Qi and Dissipating Depression Herbs group)were enrolled,and the rate of score reduction after treatment with MADRS,HAMA and SDSS increased compared with the pre-treatment treatment with the extension of the drug taking time.The difference between the MADRS and SDSS reduction rates in the Invigorating Qi and Dissipating Depression Herbs group on taking the drug for half a year and the SDSS reduction rate on one year of taking the drug were statistically significant compared with the Western medicine group,and there was no significant difference compared with the integrated Chinese and Western medicine group.On one and a half years and two years of medication,the integrated Chinese and Western medicine group had more advantages in MADRS reduction rate than the Invigorating Qi and Dissipating Depression Herbs group.The recurrence rates of depression in the three groups within 2 years were 20.9％,30.5％and 36.0％,and the difference was not statistically significant,and the length of taking medication was used as a protective factor by logistic regression analysis.The incidence rates of suicidal thoughts were 44.8％,19.1％and 17.5％,and the differences were statistically significant,and the exposure factors and income level were the protective factors by logistic regression analysis.Conclusion Invigorating Qi and Dissipating Depression Herbs can significantly improve the depressive state of patients,promote the recovery of social function,reduce the occurrence of long-term suicidal ideation,and appropriately extend the time of taking medicine can increase the long-term efficacy and reduce recurrence.

Kaixin Jieyu Pills Up-Regulated PPARα/FGF21/FGFR1 Pathway to Improve Depression-Like Behavior in Chronic Unpredictable Mild Stress Model Rats / 世界科学技术-中医药现代化

Objective To explore the effects of Kaixin Jieyu Pill(KJP)on peroxisome proliferator-activated receptor alpha(PPARα),serum and hippocampal tissue fibroblast growth factor 21(FGF21)and hippocampal tissue fibroblast growth factor receptor 1(FGFR1)in rats with depression model.Methods A rat chronic stress model was prepared using the chronic unpredictable mild stimulus method(CUMS)to observe behavioral changes in depression.Hippocampal FGF21,FGFR1 and liver PPARα protein and mRNA expression levels were measured in hippocampal tissues by western blot and real-time fluorescence quantification(RT-qPCT).Results The expression levels of PPARα,FGF21 and FGFR1's protein and their mRNA were dramatically decreased in the CUMS model rats compared with the normal group(P<0.001).KJP could modify the depressive-like behaviors of rats(P<0.001),upregulate the protein expression level of PPARα,FGF21,and FGFR1(P<0.05,P<0.01,P<0.01);markedly modify the mRNA expression levels of PPARα,FGF21,and FGFR1(P<0.001,P<0.01,P<0.01).Conclusion PPARα/FGF21/FGFR1 pathway may participate in the pathogenesis of depression;upregulation of PPARα/FGF21/FGFR1 pathway may be related to the antidepressant mechanism of KJP.

Chief physician SUN Wuquan's experience collection in treating neck-type cervical spondylosis with Tuina therapy / 针灸推拿医学（英文版）

The article analyzes chief physician SUN Wuquan's empirical characteristics in treating neck-type cervical spondylosis:disease differentiation combined with pattern differentiation,emphasizing the assessment of tendons and bones,with DING's Tuina(Chinese therapeutic massage)manipulations and static Gongfa(Qigong exercise)as the predominant treatment,inherits the academic features of DING's Tuina school,"paying equal attention to tendons and bones,putting function first";thus provides a reference for treating neck-type cervical spondylosis with Tuina therapy.

A retrospective study on 53 cases of subcutaneous tissue or subpectoral space implantation for breast reconstruction in breast cancer / 中华内分泌外科杂志

Objective:To investigate the feasibility of the surgical mode of immediate implant-based breast reconstruction (IIBR) with silicone implants under subcutaneous tissue directly after the total mastectomy in breast cancer.Methods:Data of 53 patients who underwent (skin-sparing mastectomy, SSM) or (nipple-areola-complex-sparing mastectomy, NSM) combined with IIBR in Department of Breast Surgery, Maoming People’s Hospital were retrospectively analyzed. Patients were divided into two groups, 31 cases with the silicone implant placed in different anatomical locations of the chest wall, including subcutaneous tissue, and 22 cases with subpectoral space implantation followed NSM or SSM. The two groups were compared in terms of the short-term and long-term complications, as well as the aesthetic outcome. Within 12 months the local recurrence rate was collected to evaluate the treatment safety of the two groups preserving the thickness of subcutaneous adipose after NSM or SSM.Results:There was no nipple-areola-complex (NAC) or skin flap for both groups, and the time of removing the drainage tube had no significant difference ( P>0.05) . There was no significant difference between the two groups in terms of the short-term complications within 6 months (repeated local infection and unknown effusion occurrence) , the long-term complications after 6 months (local skin with wrinkles sign, prosthesis displacement, and grade III-IV capsular contracture ( P>0.05) . However, the subcutaneous tissue implant group were superior ( P<0.05) in cosmetic outcome because of the breast had better symmetry. What’s more, no local tumor recurrence occurred in either group within 12 months. Conclusions:IIBR of subcutaneous tissue implantation (without patches) is an economical, novel, safe, and effective surgical mode for breast reconstruction, and the key to this operation mode depends on quality control of surgical procedures and the thickness of skin flap ≥ 1cm covering silicone implants. However, due to the cases enrolled in this study is not enough and short follow-up time, further clinical studies are still needed.

Clinical efficacy observation of spine subtle adjusting manipulation for postpartum low back pain / 针灸推拿医学（英文版）

Objective: To explore the clinical efficacy of spine subtle adjusting manipulation for postpartum low back pain (PLBP). Methods: A total of 76 patients with PLBP were randomized into a control group and a treatment group, with 38 cases in each group. The control group was treated with core muscle strengthening exercises, and the treatment group was treated with spine subtle adjusting manipulation. After 3 weeks of treatment, the clinical efficacy was observed, and the visual analog scale (VAS) score and Oswestry disability index (ODI), and the changes of lumbar Cobb angle and pelvic rotation were compared between the two groups. Results: The total effective rate of the treatment group was 92.1％, and that of the control group was 78.9％. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS score and ODI in both groups decreased, and the intra-group differences were all statistically significant (P<0.05). There were no intra-group statistical differences in the lumbar Cobb angle or pelvic rotation in the two groups (P>0.05). After treatment, there were no statistical differences in the lumbar Cobb angle or pelvic rotation between the two groups (P>0.05); the VAS score and ODI in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion: Spine subtle adjusting manipulation can effectively relieve the pain for patients with PLBP, and improve their daily activity function.

Early rehabilitation strategies for severe neurological diseases in children / 中国小儿急救医学

Most children with severe neurological diseases will survive through early life support, but that inevitable legacy of varying degrees of neurologic impairment, which will bring burden of economy and spirit to the society and family.Recently, the children′s intensive rehabilitation medicine has been gradually applied to clinic, emphasizing that the early rehabilitation intervention to prevent complications and actively improve functions.The study gave a brief introduction on the common neurological dysfunction, principle of management, therapeutic strategy for children with severe neurological diseases.

Characteristic analysis of 13 children with Alagille syndrome / 中华实用儿科临床杂志

Objective:To explore the characteristics of patients with Alagille syndrome(ALGS), so as to provide evidence for early clinical diagnosis.Methods:The clinical data of 13 children diagnosed with ALGS in Children′s Hospital of Chongqing Medical University from February 2014 to November 2018 was retrospectively analyzed, and some children were followed up.Results:Among the 13 patients, 12 cases(92.3%) had cholestasis, 8 cases(61.5%) with heart malformation, 5 cases(38.5%) with characteristic facial features, 5 cases(38.5%) with pruritus, and 1 case(7.7%) with a positive family history.Among the 7 pediatric ophthalmologists, 2 patients suffered from ocular lesions.Seven patients underwent spine radiography, and 1 patient had typical butterfly vertebra.In the 9 cases with hepatic pathology, 4 cases had partial hepatic sinus pressure or occlusion, 1 case had no small bile duct in part of the portal area, 4 cases had small bile duct hyperplasia, and 5 cases underwent biliary tract exploration.Genetic testing of 12 children with ALGS showed JAG1 gene mutation in 8 cases and NOTCH2 gene mutation in 4 cases.Among the 11 followed up patients, 8 cases were in stable condition, 1 patient with progressive cirrhosis was registered for liver transplantation, 1 patient died of liver failure, and 1 patient developed with drug-induced liver injury at the age of 4 months had progressive liver failure, and the jaundice was gradually subsided after liver transplantation. Conclusions:ALGS may appear on multiple systems involvement, and it demonstrates variable clinical expressivities and incomplete penetrance, thus bring certain difficulties to clinical diagnoses.It′s easily misdiagnosed as biliary atresia in infancy.Genetic testing is integral in the diagnosis of ALGS.

In vitro expression of sodium taurocholate cotransporting polypeptide in bone marrow mesenchymal stem cells and its role during HBV infection / 中华微生物学和免疫学杂志

Objective:To investigate whether in vitro cultured human bone marrow mesenchymal stem cells (BMSCs) express sodium taurocholate cotransporting polypeptide (NTCP), assess their susceptibility to hepatitis B virus (HBV) infection and analyze the role of NTCP during HBV infection. Methods:BMSCs were infected with HBV-positive serum under different conditions. HBV DNA load in cell culture supernatants as well as in BMSCs and the amount of hepatitis B virus surface antigen (HBsAg) and hepatitis B virus e antigen (HBeAg) in cell culture supernatants were detected. To analyze the role of NTCP, BMSCs were first transfected with small interfering RNA targeting NTCP (NTCP-siRNA) and then infected with HBV-positive serum under different conditions. Virus loads and the amount of HBsAg and HBsAg were also detected. Western blot assay was performed to measure the expression of NTCP in BMSCs in each group.Results:In vitro cultured adherent BMSCs were susceptible to HBV infection albeit with a really low efficiency, but the infection efficiency was significantly increased when infecting the BMSCs in suspension. NTCP was expressed in BMSCs and the expression could be upregulated during HBV infection, especially in BMSCs in suspension. HBV infection was blocked when BMSCs were transfected with NTCP-siRNA. Conclusions:In vitro cultured human BMSCs were susceptible to HBV infection and the expressed NTCP served as a functional receptor for HBV. Human BMSCs could be used as a highly susceptible and stable cell model that needed no molecular adjuvant modification for research on the early stages of the HBV life cycle and for development of antiviral therapy.

Kinematics and Surface Electromyography of Upper Limbs in Motor-delayed Children and Normal Children in Crawling Stage / 中国康复理论与实践

Objective To detect kinematics and surface electromyography (sEMG) of upper limbs in normal children and motor-delayed children for clinical assessment. Methods From December, 2015 to June, 2016, twelve healthy children and thirteen children with motor de-velopmental delay less than two years old were analyzed kinematics with Motion Analysis system and sEMG. Results The angle of motion of right shoulder was more in the motor-delayed children than in the normal children (t=2.576, P<0.05). The difference of root mean square values of bilateral triceps brachii was more in the motor-delayed children than in the normal ones (t=2.448, P<0.05). Conclusion Detecting kinematics and sEMG may supply information for early personalized treatment strategy.

Application of nursing safety management system in operating room / 现代临床护理

Objective To establish nursing safety management system in the operating room and explore the effect of clinical application.Methods Toally 350 patients with surgical treatment from January to December 2013 were assigned as the control group,where routine nursing safety management was conducted.Another 350 patients from June 2014 to June 2015 were as the observation group,where nursing safety management system was used in the operating room.The two groups were compared in terms of adverse events,the passing rate of quality and safety.Result As compared with the contrast group,the incidence of adverse events was significantly lower and the passing rate of quality and safety was significantly higher in the observation group (P＜0.05).Conclusion Establishment of nursing safety management system can improve the nursing risk awareness,reduce the incidence of preoperative and postoperative adverse events and improve the level of nursing safety management and the quality of care.

Expression of miR-665 and Bioinformatic Analysis on Its Target Genes of Kai-Xin Jie-Yu Decoction Based on Depression Model Rats / 世界科学技术-中医药现代化

This study was aimed to detect the expression of miR-665 in the hippocampal of depression rat model treated with Kai-Xin Jie-Yu (KXJY) decoction and bioinformatic analysis of target genes of miR-665,in order to investigate the role of miR-665 in the pathogenesis of depression and the antidepressant mechanism of KXJY decoction.The rat model of chronic stress depression was established and then treated with KXJY decoction for 42 days.The total RNA from hippocampus tissues was extracted.And the relative expression of miR-665 in hippocampus of rats in each group was detected by RT-qPCR.TargetScan and microRNAorg databases were used to predict target genes for miR-665.DAVID database was used to classify GO function and to analyze KEGG signaling pathway of target genes.The results showed that compared with the normal group,the expression level of miR-665 in hippocampus of the model group was significantly higher with significant difference (P ＜ 0.01).Compared with the model group,the expression level of miR-665 in hippocampus of Chinese medicine group and western medicine group decreased significantly with significant difference (P ＜ 0.01).The biological functions of miR-665 target genes were mainly concentrated in the response to organic substance.The signal pathway was mainly concentrated in N-Glycan biosynthesis.It was concluded that miR-665 may be involved in the pathological process of depression,by correcting the abnormal expression of miR-665,which may be one of the antidepressant mechanisms of KXJY decoction.Through the analysis and prediction of the target genes,it provided a certain direction and theoretical basis for further study on the specific mechanism of KXJY decoction intervention on miR-665.

Effects of Kai-Xin Jie-Yu Pill on Neural Plasticity in Rats with Depression / 世界科学技术-中医药现代化

This article was aimed to investigate the function and mechanism of Kai-Xin Jie-Yu (KXJY) pill on depression.The depression model rats were established by chronic unpredictable mild stress and separation.The sucrose preference test and Morris water maze (MWM) were performed.The regulation effects of neural plasticity-related genes including glycogen synthase kinase-3β (GSK-3β),cAMP-response element binding protein (CREB),5-hydroxytryptamine 2C receptors (HTR2C),and vascular endothelial growth factor (VEGF) were determined.The results showed that among depression model rats,KXJY pill significantly increased the sucrose preference and the escape latency of MWM in a certain extent.The neural plasticity-related genes including GSK-3β and HTR2C mRNA were decreased significantly,whereas CREB and VEGF mRNA were increased significantly with the treatment of KXJY pill.It was concluded that KXJY pill had the function of reducing depression-like behavior,which might be mediated by the regulation of GSK-3β,CREB,HTR2C and VEGF.

Effects of Kaixin Jieyu Pills on monoamines and BDNF in rats with vascular depression / 中成药

AIM To aim at investigating the function of Kaixin Jieyu Pills (Ginseng Radix et Rhizoma,Bupleuri Radix,Morindae officinalis Radix,etc.) to vascular depression and their mechanism of action.METHODS A vascular depression model of rat was established by chronic unpredictable mild stress and separation after ligation of the bilateral common carotid arteries.The rats were treated with Kaixin Jieyu Pills and fluoxetine hydrochloride (FLU) for 28 days,respectively.The sucrose preference test and open-field test were performed.Cerebral perfusion was investigated with a Perfusion Speckle Imager.The monoamines including serotonin,dopamine and noradrenaline,and brain-derived neurotrophic factor (BDNF) were determined with ELISA and Western bolt,respectively.RESULTS Kaixin Jieyu Pills significantly increased sucrose preference,moving distance and cortical blood flow.Kaixin Jieyu Pills could upregulate,to different extents,the expressions of monoamines,including serotonin,noradrenaline and dopamine,and BDNF.Kaixin Jieyu Pills had a function similar to FLU in behavior,upregulating monoamines and BDNF,but it is superior to FLU in cortical blood flow.CONCLUSION Kaixin Jieyu Pills has the advantage of reducing the depression-like behavior and improving cerebral hypoperfusion,which might be mediated by the upregulation of the serotonin,noradrenaline and BDNF.

Study on cardiovascular disease risk in inpatients with schizophrenia / 中国神经精神疾病杂志

Objective To describe the cardiovascular risk profile of inpatients with schizophrenia and estimate the 10-year CVD risk in schizophrenia patients. Methods Four hundred sixty-six randomly selected cases of schizophrenia patients and 507 health controls were included in the study. Body mass index (BMI), Fasting blood glucose (FBG), triglyceride (TG),,total cholesterol (TC), smoking rate (smoking people/total people), Framing-ham Risk Score (FRS), high density lipoprotein-cholesterol (HDL-C) and age of the vessel (VA). The 10-year cardiovascular risk(FRS) and age of the vessel (VA) were assessed using the Framing-ham Risk Score. Results 10-year CVD risk was significantly higher in patients with schizophrenia than in control group [(6.71 ±6.95)％ vs. (4.76 ±3.07)％], (P<0.05). Comparing with the control group, smoking prevalence[(41％) vs. (19％)], MS[(25％) vs. (17％)], BMI[(23.67 ±3.61)kg/m2 vs. (21.73±4.11)kg/m2] and VA[(46.7±15.3) vs. (43.7±9.8)] were higher in patients group. SBP[(119.86±14.90)mmHg vs. (128.10±15.41)mmHg] and HDL-C [(1.08±0.27)mmol/L vs. (1.38±0.22)mmol/L] were lower in patients group than in the healthy controls. The FRS score of the patient group was positively correlated with BMI, FBG level and SBP, waist circumference and smoking index (P<0.05) and was negatively correlated with the levels of HDL-C. Multivariate Linear Regression analysis demonstrated that FRS was correlated with FBG (β=0.181,P<0.01)、SBP (β=0.149,P<0.01)、HDL-C (β=-0.107,P<0.01) and smoking index(β=0.554,P<0.01). Conclusion The risk of cardiovascular disease in patients with schizophrenia over the next 10 years is 6.7％, which is significantly higher compared with the control group. Fasting blood glucose, systolic blood pressure, high density lipoprotein, smoking may be associated with 10-year CVD risk of schizophrenia patients.

A study on the relationship between intrauterine infection and early-onset neonatal sepsis / 中国新生儿科杂志

Objective To study the relationship between intrauterine infection and early neonatal sepsis.Method From October 2015 to September 2016,the clinical data of pregnant mothers and their newborns in Shenzhen Longhua District Central Hospital were collected,and data of Shenzhen People's Hospital from January 2016 to June 2016 were collected.100 pairs of pregnant mothers and their newborns with confirmed or suspected intrauterine infection were selected as the observation group,and another 100 pairs without intrauterine infection during the same period as the control group.The ratio of term infants vs.premature infants was 1∶ 1.The complete blood count (CBC),CD64,procalcitonin (PCT) and C-reactive protein (CRP) were measured in peripheral blood of all mothers on the day of delivery.The CBC,CD64,CRP,PCT,blood culture of both umbilical venous blood and peripheral blood in neonates were examined and the pathological examination of placenta was performed.Result The positive rate of placental pathology and umbilical cord blood culture in observation group were significantly higher than that in the control and the positive rate in preterms was higher than the terms in observation group (P ＜ 0.05).No significant differences existed between term and premature newborns on the positive rate of peripheral blood culture (P ＞ 0.05).The positive rate of blood culture from umbilical cord blood was higher than peripheral blood in observation group (P ＜ 0.05),but no significant difference in control group (P ＞ 0.05).The incidence of septicemia in term and premature newborns in observation group was significantly higher than the control group (P＜ 0.05).The CD64,PCT in mother's peripheral blood and umbilical cord blood,and CRP in mother's blood were all higher than the control group,the differences were statistically significant (P ＜ 0.05),but CRP in umbilical cord blood in both group were similar (P ＞ 0.05).The area under ROC curve of CD64 and PCT in mother's peripheral blood,CD64 and PCT in umbilical cord blood to diagnose early-onset septicemia in newborns was 0.755,0.793,0.852 and 0.811,respectively.Conclusion The risk of neonatal infections is significantly increased because of intrauterine infection.Combination of peripheral and umbilical blood cultures can increase the accuracy of sepsis diagnosis.Both CD64 and PCT in umbilical cord blood and maternal blood can be used as indicators of intrauterine infection with a predictive value in the diagnosis of early-onset neonatal sepsis.

Test and clinical significance of immunoglobulin and complements in hand foot and mouth disease combined with acute flaccid paralysis / 中国综合临床

Objective To study the serum immunoglobulin IgG,IgM,IgA and complements C3,C4 level changes in hand foot and mouth disease (HFMD) combined with acute flaccid paralysis (AFP).Methods The cases were divided into three groups in this study,including 30 cases of HFMD,30 cases of HFMD combined with AFP,and 30 cases of healthy(normal control group).Immunoturbidimetric assay was used to test the level changes of IgG,IgM,IgA,and complements C3,C4.Results The IgG,IgA,C3 and C4 in HFMD combined with AFP group were (5.49±1.04) g/L,(0.39±0.27) g/L,(0.65.±0.19) g/L and (0.16.±0.11) g/L respectively,lower than those in HFMD group((7.07± 1.63) g/L,(0.55±0.32) g/L,(0.97.±0.18) g/L,(0.23.±0.09) g/L) and normal control group((9.58±1.42) g/L,(0.81±0.33) g/L,(1.28.±0.25) g/L,(0.34.±0.16) g/L),there were statistically significant differences among groups(F=12.04,1.84,1.65,1.29;P=0.031,0.020,0.018,0.025).However,the expression of IgM in HFMD combined with AFP group was (1.34±0.26) g/L,higher than that in HFMD group((1.02±0.29) g/L) and normal control group ((0.76±0.28) g/L),the difference was statistically significant(F=3.62,P=0.014).Conclusion HFMD combined with AFP exists severe humoral immune dysfunction,which provides a theoretical evidence for the prevention and treatment of HFMD combined with AFP.

Temperature instability of Prader-Willi syndrome in an infant / 临床儿科杂志

ObjectiveTo study the clinical characteristics of the temperature instability in Prader-Willi syndrome (PWS). MethodsThe clinical characteristics of one case of PWS with recurrent fever were retrospectively analyzed.ResultsA 5-month-old boy who had such clinical characteristics as low central muscle tension, sucking weakness, feeding dififculties, cryptorchidism and white skin was diagnosed as PWS by chromosomal microarray analysis and methylation-speciifc PCR. In the course of the disease, the infant presented recurrent fever. The pathogenic bacteria culture and virus antibody detection showed negative, and the treatment of reducing fever, anti-infection and immune support were ineffective.ConclusionsThe cause of the recurrent fever is unknown and central fever is suspected. Whether the temperature instability is the clinical feature of PWS still needs a lot of clinical researches.

Development of the School Refusal Behavior Questionaire for Children / 中国心理卫生杂志

Objective:To develop a Child School Refusal Behavior Rating Scale(SRBQC)and examine its reliabilities and validities. Methods:Based on literature review,interview,and open-ended questionnaire,124 origi-nal items were developed. Totally 573 students were recruited to complete the test version. After item and explorato-ry factor analysis,the formal scale-SRBQC was got. Totally 946 students were tested with formal version for further confirmatory factor analysis,internal consistency reliability and composite reliability. The criterion validity was test-ed with the Social Anxiety Scale for Child (SASC). Totally 41 students were retested for test-retest reliability with 2 weeks interval. Results:The formal version of SRBQC included 19 items. Exploratory factor analysis generated 5 factors which account 59. 793% of the variance in all,the results of confirmatory factor analysis showed that SR-BQC had a good construct validity (χ2 =329. 51,df=142,χ2/df=2. 32,CFI=0. 97,GFI=0. 93,IFI=0. 97,NFI=0. 95,NNFI=0. 96,RMSEA=0. 05,SRMR=0. 05). The SRBQC scores were positively correlated with the SASC scores (r=0. 18-0. 34,Ps<0. 05 ). The Cronbach coefficients were 0. 87 for the total questionnaire and 0. 55 -0. 78 for the 5 factors. The test-retest reliabilities were 0. 84 for the total questionnaire and 0. 66 -0. 78 for the 5 factors. Conclusion:The reliability and validity of the School Refusal Bevior Questionaire for Children(SRBQC) meet the needs of psychometrics.