Objective Prematurity is one of the leading causes of death and disability in neonates. To improve the management of premature infants, the Subspecialty Group of Neonatology, Pediatric Society, Chinese Medical Association established the guideline on the 7th National Neonatal Academic Conference in October 2004. The guideline makes references to management at birth, respiration management, prevention and treatment of cerebral injury of premature infants, prevention and treatment of infection, maintenance of stable blood glucose, nutritional management, management of feeding intolerance, fluid balance, management of patent ducts arteriosus (PDA), prevention and treatment of anemia, treatment of jaundice of prematurity, prevention and treatment of retinopathy of prematurity (ROP), hearing screening, nursing and follow-up following discharge.

Objective 8-iso-8-iso-prostaglandin F 2α (8-iso-PGF 2α) is an index that can sensitively and specifically reflect peroxidation caused by increased free radicals after reperfusion. N-acetlycysteine (NAC) acts as an effective scavenger for free radical cleaning in the body. This study aimed to analyze the correlation of 8-iso-prostaglandin F 2α level between serum and myocardial tissue, and to investigate the therapeutic effect of NAC and the significance of serum 8-iso-PGF 2α level in rats with acute myocardial ischemia. Methods Forty-five male manhood Wistar rats were divided into three groups (15 rats in each group): Ischemia, NAC, and Control groups. Rats in the NAC group were given gastric lavage with NAC (0.1g/kg per day) for three weeks. Two weeks later the Ischemia and NAC groups were subjected to acute myocardial ischemia induced by intraperitoneal injection of pituitrin (20 U/kg), and the elevation of the ST segment in the ECG was used as the index of myocardial ischemia. The Control rats were injected intraperitoneally with normal saline. The 8-iso-PGF 2α contents in serum and myocardial tissue were determined by ELISA. Results Compared with the Control group, the 8-iso-PGF 2α contents in serum and myocardial tissue of the Ischemia group were significantly higher (60.4±13.7 pg/mL vs 187.4±45.8 pg/mL and 88.6±16.9 pg/mL vs 259.3±47.5 pg/g, both P< 0.01) In the NAC group, 8-iso-PGF 2α concentrations of serum and myocardial tissue were 88.2±16.4 pg/mL and 109.4±24.7 pg/g respectively, lower than those in the Ischemia group (P < 0.01). The 8-iso-PGF 2α levels of serum and myocardial tissue were positively correlated (r=0.865, P<0.01). In comparison with the controls, ST segments of ECG in rats with myocardial ischemia elevated and the peak of ST segments occurred 45 minutes after myocardial ischemia (0.34±0.05 mV) (P < 0.01). Pre-treatment with NAC improved myocardial ischemia (the elevation of ST segment was only 0.18±0.05 mV). Conclusions The level of 8-iso-PGF 2α increased in both serum and myocardial tissues of rats with acute myocardial ischemia. The serum level of 8-iso-PGF 2α can be used to evaluate the severity of myocardial ischemia. NAC reduces the free radical damage in myocardial tissues, and therefore, it may improve the amelioration of the heart during myocardial ischemia.

Objective The intestine is one of the most seriously injured organs during neonatal asphyxia. But a model for studying the perinatal intestinal injury caused by asphyxia is absent. This paper described a model of intestinal damage produced by reversible intrauterine ischemia in rats. Methods The model of acute reversible intrauterine ischemia was established by clamping the arteries and veins on one side of the uterus and ovaries in pregnant Wistar rats (E21) for 20 minutes. The fetal rats on the occluded side of the uterus were used as the Ischemia group and the rats on the other side were used as the Control group. After 20 minutes of vascular occlusion, the uteri were opened and the pups were removed. In each group, 18 pups were sacrificed at 0, 24, 48 and 72 hrs after ischemia, respectively. The intestinal mucosal damage index (IMDI) was evaluated. Results After ishemia, the pups in the Ischemia group were cyanotic or pale, listless, and hypopneic, while the control pups manifested normal. The intestinal mucosa of controls were not damaged. In the Ischemia group, intestinal damage reached a peak at 48 hrs post-ischemia, with an IMDI that was significantly increased above controls (3.40±0.16 vs 0.00±0.00, P<0.01). At 72 hrs post-ischemia, the changes of intestinal tissues had largely recovered and the IMDI decreased to 0.60 ± 0.21. Conclusions The animal model of asphyxia induced perinatal intestinal injury can be established by clamping the arteries and veins on one side of the uterus and ovaries in pregnant rats.

Objective To examine the mRNA and protein expressions of cyclooxygenase-2 (COX-2) and the kinetic changes of three metabolites (PGI 2, PGE 2 and TXA 2) of COX-2 in kidney tissues of fetal rats after intrauterine distress (ID), and to explore the possible roles of COX-2 in the pathogenesis of kidney impairment of fetal rats after ID. Methods A model of intrauterine ischemia and hypoxia of fetal rats was made by occluding one side of vessels supplying two horn uteri. The fetal rats in the other side were used as Sham-operation group (n=22). After 30 minutes of blood occlusion, reperfusion started. Pups were removed 0, 0.5, 2, 6, 12, 24 and 30 hrs post-reperfusion respectively (n=20 for each time point). After the renal tissues of fetal rats were homogenized, RT-PCR, Western blotting and radioimmunoassay methods were used to detect the mRNA and protein expressions of COX-2 and the kinetic changes of PGI 2, PGE 2 and TXA 2 concentrations. At the same time, hematoxylin-eosin staining was used to observe the histopathological changes of the kidney.Results After intrauterine ischemia, hypoxia and reperfusion, the expressions of COX-2 protein and gene in fetal rat kidney were significantly up-regulated. Compared with the Sham-operation group, the concentrations of 6-keto-PGF 1α and PGE 2 began to increase following 2 hrs of reperfusion, and reached a peak 12 hrs and 24 hrs after reperfusion respectively. The TXB 2 concentration in the Ischemia-reperfusion group was not different from the Sham-operation group at any reperfusion time point.Conclusions Intrauterine ischemia, hypoxia and reperfusion can induce the up-regulation of COX-2 expression in fetal kidney at the transcriptional level. COX-2 may play a protective role in ischemic impairment of fetal kidney through PGI 2 and PGE 2. It is suggested that COX-2 inhibitors should not be used for kidney impairment patients during the perinatal period.

Objective The intestinal trefoil factor (ITF) is closely related with gastrointestinal epithelial cells injury repair. Studying the effects of ITF on necrotizing enterocolitis (NEC) would be helpful to the treatment of NEC. This research investigated the effect of ITF on intestinal histopathological changes, expression of cyclooxygenase-2 (COX-2 ) and the production of prostaglandin E 2 (PGE 2 )and thromboxane B 2 (TXB 2) in neonatal rats with NEC.Methods Forty one-day-old Wistar rats were randomly divided into 5 groups: Groups A, B, C, D and E (n=8 each). Group A served as the normal control group. Rats in Groups B, C, D and D were made into NEC models by hypoxia and re-oxygenation for 3 consecutive days. Groups D and E were treated with 0.5 mL ITF ( 0.5 mg) intraperitoneal injection or 0.2 mL ITF ( 0.2 mg) subcutaneous injection once respectively after damage, while Groups B and E were injected with normal saline intraperitoneally or subcutaneously respectively. On the 4th day all the subjects were sacrificed and intestinal tissues were obtained to examine the histological changes, COX-2 expression, and PGE 2 and TXB 2 productions. Results Intestinal histopathology of rats in Group A was normal, and the pathologic scores were 0. As compared with the corresponding NEC group(Groups B and C), histopathological injuries of NEC were remarkably relieved after ITF treatment (Groups D and E)(P < 0.01). The pathologic scores of rats in Groups B and C were 1- 4, while those of Groups D and E were 0-2. PGE 2 and TXB 2 contents significantly increased in Groups B and C, while dramatically decreased after ITF treatment (in Groups D and E). No significant differences were observed for the PGE 2 and TXB 2 contents between Groups D, E and A. Immunohistochemistry staining indicated positive expression of COX-2 in Groups B and C, which were significantly higher than Groups A, D and E (P < 0.05). Mild positive expression of COX-2 was observed in Groups D and E, which was stronger than Group A. Conclusions ITF can decrease the productions of PGE 2 and TXB 2 by suppressing the expression of COX-2, which may be underlying protective mechanisms of ITF on NEC.

Objective In order to establish a foundation for further epidemiological survey of preterm infants throughout China, this paper collected and analyzed medical documents of premature infants from some cities of China. Methods A total of 6 179 preterm infants from 77 hospitals in 16 provinces, municipalities or direct jurisdiction cities in China between January 2002 and December 2003 were enrolled in this study. High risk factors and complications associated with premature birth and incidence and outcome of premature infants were investigated retrospectively.Results The incidence of the preterm infant was 7.8% in neonates born in the department of obstetrics, accounting for 19.7% in hospitalization neonates and with a gender constituent ration of 1.67∶1 (boy∶girl). The preterm infants born at gestational age between 32-36 weeks accounted for 63.5% and those with body weights less than 1 500 g accounted for 32.3% in all premature infants. The most common precipitating factor of premature birth was the abortion history of the mother ( 36.8%), followed by multifetation ( 20.8%),premature rupture of membranes ( 19.8%) and pregnancy-induced hypertension syndrome (12.6%). The most common complication was respiratory system diseases (52.3%), followed by central nervous system disease (33.7%), hyperbilirubinemia (22.6%) and infectious diseases (11.3%),digestive system diseases(10.6%) and circulation system diseases (9.0%). The incidence of complications decreased with the increase of body weight. With the increase of gestational age, a significant decrease in the incidence of complications except hypoxia-ischemic encephalopathy(HIE) was also observed. The desirable outcome of the premature infant rose with the increase of gestational age or body weight.Conclusions The investigation demonstrated the common causes of premature birth and the factors related to the outcome of the premature infant. It provides a basis for decreasing the incidence and improving the prognosis of the premature infant.

Objective To examine serum vitamin E levels in premature infants. Methods Serum concentrations of two isomers of vitamin E, α-tocopherol and γ-tocopherol, were measured by electrochemistry in 16 premature infants and 16 full-term infants. Results Compared with term infants, the serum concentrations of α-tocopherol and γ-tocopherol in premature infants were significantly lower (217±120 ng/mL vs 411±284 ng/mL and 889±460 ng/mL vs 2 177±1 031 ng/mL, respectively, both P<0.05).Conclusions Premature infants have a much lower serum vitamin E level. Vitamin E supplementation is thus essential soon after birth.

Objective The expression of vascular endothelial growth factor (VEGF) is associated with the pathogenesis and prognosis of solid tumors, however its relationship to childhood acute leukemia has not yet been identified. This study determined the expression of VEGF and its receptors in children with acute leukemia in order to study their relationships to the activity of childhood acute leukemia.Methods The mRNA of VEGF, and its receptors Flt-1 and KDR were detected in bone marrow mononuclear cells by the reverse transcription-polymerase chain reaction and the plasma VEGF levels were measured using immunoasssay in 21 children with initial or recurrent untreated acute leukemia and 20 leukemia children in complete remission. The bone marrow samples from 5 healthy volunteer children and plasma samples from 20 healthy children were used as the controls.Results VEGF and its receptors were not expressed in the samples from healthy children. KDR mRNA expression was not detected in either healthy or leukemia children. The VEGF mRNA was expressed in 90% of patients with initial/recurrent acute leukemia, which was higher than in patients in complete remission (30%; P<0.001) and healthy children (P<0.001). The patients with acute leukemia also had a significantly higher Flt-1 mRNA expression level (86%) than patients in complete remission (15%; P<0.001) and healthy children (P<0.001). There was no difference in the expression levels of VEGF and Flt-1 between patients in complete remission and healthy children. The plasma VEGF concentration of initial/recurrent patients (405±270 pg/mL) was much higher than that of patients in complete remission (136± 98 pg/mL; P<0.05) and normal controls (91±41 pg/mL; P< 0.01). There was no difference in the plasma VEGF concentrations between the patients in complete remission and healthy children. Conclusions The expression of VEGF and the receptor (Flt-1) may play an important role in the development of childhood leukemia.

Objective With the extensive use of the third-generation antibiotics, the resistant strains of extended spectrum β-lactamases (ESBLs)-producing bacteria are constantly increasing resulting in an outbreak of nosocomial infectious. This study aimed to investigate the positive rate of ESBLs-producing bacteria and the incidence of their drug resistance to 12 common antibiotics as well as risk factors associated with this bacteria infection in children with hospital acquired pneumonia (HAP). Methods ESBLs-producing bacteria were examined by the disc diffusion confirmatory test and the double disc synergy test in Gram-negative bacteria from sputum in children with HAP. The incidence of drug resistance to 12 common antibiotics was compared between the positive and negative ESBLs-producing bacteria. The risk factors for ESBLs producing bacteria infection were investigated by logistic regressive analysis. Results Forty-three positive ESBLs-producing bacteria strains were isolated from 109 Gram-negative bacteria strains in 95 children with HAP, with a positive rate of 39.4%. Of the bacteria, Escherichia coli accounted for 13.8%, 9.2% for Klebsiella pneumoniae, 8.3% for bowel bacilli, and 8.3% for other bacteria. The incidence of drug resistance of positive ESBLs- producing bacteria to cefozolin, ceclor and cefotaxime was significantly higher than that of non-ESBLs-producing bacteria. In either positive or negative ESBL-producing bacteria, the incidence of drug resistance to imipenem was low (0-11%) and to quinolone and aminoglycoside it was below 40%. Logistic regressive analysis showed that the independent risk factors for ESBLs-producing bacteria infection included the duration of cefotaxime treatment (>3 d), admission to the Intensive Care Unit and invasive operations. The first factor was a predominant one. Conclusions Imipenem, quinolone and aminoglycoside may be recommended in the treatment of ESBLs-producing bacteria infection. Risk for ESBLs-producing bacteria infection is multifactorial. It is necessary to reasonably use antibiotics, stress the asepsis principle and reduce invasive operations as much as possible in order to decrease ESBLs-producing bacteria infection.

Objective This study examined the colonic transit time and anorectal motor in children with constipation. Methods Twenty-eighty children with constipation (Constipation group) and 43 healthy children (Control group) were enrolled in this study.Total gastrointestinal transit time (TGITT), left colonic transit time (LCTT), right colonic transit time (RCTT) and rectosigmoid colonic transit time (RSTT) were measured by the simplified method of radiopaque makers.Meanwhile, anorectal vector manometry was performed. The Constipation group was subdivided into Slow-transit group and Normal transit group according to the TGITT to explore the value of anorectal manometry in different types of constipation. Results The TGITT, LCTT and RSTT of the Constipation group were significantly longer than those in the Control group (92±56 hrs vs 29±8 hrs, P< 0.01; 17±13 hrs vs 7±4 hrs, P< 0.01; 62±29 hrs vs 13±6 hrs, P< 0.01), while there was no significant difference in the RCTT between the two groups. Compared with that of the Control group, the anorectal maximal squeezing pressure (MaxSP) of the Constipation group was significantly higher ( 216±44 mmHg vs 190±38 mmHg, P< 0.05). In contrast,the anorectal vector symmetric index (VSI) was significantly lower (0.71±0.06 vs 0.84±0.08, P< 0.05). The anorectal vector volume (VV) was the same for the two groups. There were no significant differences in MaxSP, VV and VSI between the Slow-transit and Normal transit groups. Conclusions The colonic transit time is prolonged and anorectal dynamic disorder is present in children with constipation. Anorectal manometry is needed for any of the constipated children no matter who has normal or abnormal colonic transit time.

Objective This study aimed to reporting the experience in the treatment of cardiac malformation using coil implantation in children. Methods Between February 1995 and January 2004, 133 children (63 males and 70 females, with an age range of 0.8- 13.0 years) with cardiac malformation were referred for closure with coils. The efficacy evaluation was based on: 1) immediate success of the closure as measured by transthoracic echocardiography (TTE); 2) short-, medium-, and long-term follow-up after implantation as assessed by TTE and electrocardiograph; and 3) the incidence of complications. Results A total of 101 patients underwent closure of patent ductus arterious (PDA) using coil implantation. The Gianturco coil was successfully implanted in 14 cases and Duct-Occlud or Nit-Occlud coil in 87 cases. Four patients had 2 coils implantaed. The minimal diameter of PDA was 1.6± 0.6 mm (range 0.5- 3.8 mm). The immediate complete closure rate was 90.1%. This increased to 98.0% and 99.0% at 1 month and 1 year, respectively. The Gianturco coil was used to embolize the collaterals in 14 patients with cyanotic heart diseases. Five patients received 1 coil implantation and the rest had 2-4 coils. The minimal diameter of the collaterals was 3.5± 0.8 mm (range 2.1-5.0 mm). The complete closure rate was 100% at 10-15 minutes after implantation. Fourteen patients with coronary artery fistula, including 8 cases of right coronary artery-right atrial fistula and right coronary artery-right ventricular fistula and 6 cases of left anterior descending and circumflex-right atrial fistula or right ventricular fistula, underwent closure by Gianturco or Duct-Occlud coil implantation. The minimal diameter was 3.8± 1.1 mm (range 2.0- 5.1 mm). Only 1 coil was used in 11 patients, and 2-4 coils in 2 patients. The immediate complete closure rate was 38.5%(5/13), and up to 84.6% (11/13) at 1 month. Unsuccessful deployment of implantation occurred in 1 case with right coronary artery-right ventricular fistula due to the coil movement to distal pulmonary artery trees immediately after embolization. After the coil was successfully retrieved, the patient needed a surgical operation. Two patients with pulmonary arteriovenous fistula received 6 or 16 Gianturco coils implantations respectively. The systemic saturations increased from 76% to 91% and 96% respectively. Two patients underwent closure of perimembranous ventricular septal defect (VSD) with pseudoaneurysm with only 1 Duct-Occlud coil. A minimal residual shunt was seen immediately after closure and disappeared after 24 hrs. A 2 months to 4 years follow-up showed that no complications related to device implantation occurred in any patient. Conclusion Transcatheter closure using coils is safe and effective in selected cases of cardiac malformation in children.

Objective The efficacy of long-term corticosteroid inhalation and its influences on adrenal gland function and growth & development in the treatment of childhood asthma are the concerns of many doctors and parents. This study examined the efficacy and safety of long-term beclomethaone dipropionate (BDP) inhalation in the treatment of this disorder by a control study. Methods Eighty children with asthma were randomly assigned into two groups: a Study group (n=50) and a Control group (n=30). Children from the Study group were regularly given BDP inhalation treatment during the remission stage. The initial dosage was different in patients with different severity (mild:250 μg/d, medium:500 μg/d, and severe:750 μg/d). Afterwards, the dosages were adjusted according to patients′ responses to this therapy. BPD inhalation duration was from 6 months to 2.5 years. During the treatment, regular follow-ups were performed to observe therapeutic effects and to measure patients′ peak expiratory flow rate (PEFR), 24-hr-urine free cortisol concentrations, body weight and height. The asthmatic children who did not receive or received irregular BPD inhalation during the remission stage served as the Control group.Results After 6 months of BPD inhalation, the effective rate in the Study group was significantly higher than that in the Control group [90%(45/50) vs 70%(21/30), P<0.05].The PEFR of the Study group significantly increased with treatment. The children′s body weight and height were not different from the normal children. The concentrations of 24-hr-urine free cortisol were also kept normal.Conclusions Long-term BPD inhalation appears to be effective and safe in the treatment of childhood asthma.

Objective This study examined T lymphocyte phenotype and function in the peripheral blood of children with chronic tonsillitis in order to provide a basis for uncovering the pathogenesis of chronic tonsillitis. Methods The expressions of surface markers of T cell subsets, B cells and NK cells and expressions of membrane molecule of activated T cells(CD3 +/HLA-DR + T and CD3 +/CD25 +) were assayed by immunofluorescence and flow cytometry in 27 children with chronic tonsillitis (Study group) and 21 healthy children (Control group). Meanwhile, the levels of IL-2 and IFN-γ were detected using ELISA. Results CD4 + cells and CD3 +/HLA-DR + activated T cells were expressed in 25.4%± 4.5% and 3.9%±1.6% in the Study group but 28.6% ± 4.4% and 5.7%±1.9% in the Control group (P<0.05 and <0.01, respectively). The ratio of CD +4/CD8 + of T cells in the Study group was significantly decreased compared with the Control group (0.92 ± 0.18 vs 1.17 ± 0.30,P<0.01). CD19 + B cells were expressed at a lower level in the Study group (9.9% ±3.0% vs 13.1%± 5.6%, P<0.05). The levels of IL-2 and IFN-γ related to Th1 cells function were also significantly lower in the Study group than those in the Control group (P<0.01). There were no significant differences in the number of CD3 + T cells, CD8 + T cells, CD3 +/CD25 + T cells and CD3 -/CD (16+56) + NK cells between the two groups.Conclusions There are lower CD4 + cell expression and B cell expression, and T cell dysfunction and Th1 cell dysfunction may be present in children with chronic tonsillitis, which may contribute to the pathogenesis of recurrent tonsillitis.

Objective To study the pathogen distribution and drug sensitivity in childhood bacillary dysentery and to provide a basis for selecting antibiotics clinically.Methods A total of 290 children who were definitely diagnosed with bacillary dysentery by stool culture between 1998 and 2003 were eligible to this study.A drug sensitive test was performed by an improved Kirby-bauer method. Results Of the 290 cases, there were two types of positive bacterial species: Sh.sonnei (type D, n = 155) and Sh.flexneri (type B, n = 135).Between 1998 and 1999, Type Sh.flexneri was the main bacteria, while from 2000 through 2003, Type Sh.sonnei was predominant. Both Sh.flexneri and Sh.sonnei were sensitive to cefaclor, amikacin, gentamycin, and ceftriaxine, and insensitive to ampicillin and trimoxazole. Conclusions Types Sh.flexneri and Sh.sonnei bacteria were the major pathogen of childhood bacillary dysentery between 1998 and 2003. Cefaclor is an oral drug with few side effects, which can efficiently kill Shiga′s bacillus, and may be recommended in the treatment of this disorder.

Objective In recent years, the resistance of typhoid to antibiotics has increased. To seek to an effective medicine for the treatment of typhoid in children, this study examined the therapeutic effect of azithromycine, a new generation of macrolides, on this disorder.Methods Forty-five children with typhoid were randomly assigned into two groups:an Azithromycine-treated group (n=23) and a Ceftriaxone-treated group (Control,n=22). The therapeutic and side effects on the two groups were compared. Results There were no differences in the response rate to treatment between the Azithromycine-treated group and Control group (100% vs 90.9%). The time of fever relieving in the Azithromycine-treated group was 3.12±0.44 days, which was not significantly different from the Control group (3.18±0.53 days). No serious side effects were found in either group. Conclusions Azithromycine appears effective in the treatment of childhood typhoid.

Objective The incidence of autism is increasingly encountered in children, and more and more autism rating scales have come into use. This study clinically compared three autism rating scales: Autism Behavior Checklist (ABC), Clancy Autism Behavior Scale (CABS) and Childhood Autism Rating Scale (CARS), in order to provide a basis for selecting assessment method. Methods Twenty-eight cases with autism (Autism group), who all met the diagnostic standard of Diagnostic and Statistical Manual of Mental Disorders Ⅳ(DSM-Ⅳ, USA), were evaluated by ABC, CABS and CARS. The best cut-off score, specificity, sensitivity, accuracy, positive prognostic value (PPV) and negative prognostic value (NPV) of each rating scale in the diagnosis of autism were calculated. Thirty-four patients without autism served as the Control group. Results The scores evaluated by ABC, CARS and CABS in the Autism group were all significantly different from the Control group (P<0.01). The result of the CARS test had the highest coincidence to criteria of DSM-Ⅳ (Kappa=1), followed by that of the ABC test (Kappa=0.87) and that of the CABS test (Kappa=0.60). According to the receiver operator characteristic curve (ROC), the best cut-off score of ABC was 31, and its specificity, sensitivity, accuracy, PPV and NPV were 0.97, 0.89, 0.94, 0.96 and 0.92 respectively. It was more effective for children over 3 years. The best cut-off point of CARS was 30, and its specificity, sensitivity, accuracy, PPV and NPV were all 1.0. Its assessment efficacy was not associated with age. The best cut-off score of CABS was 6, and its specificity, sensitivity, accuracy, PPV and NPV were 0.91, 0.82, 0.87, 0.88 and 0.86 respectively. It was more effective for children over 3 years.Conclusions There was a high coincidence among ABC, CARS and CABS. CARS seems to be the best autism rating scale, followed by ABC and CABS.

Objective Although many studies have shown the significance of hematologic parameters in the diagnosis of thalassemia in adults, no related reports were found in neonates. This study aimed to evaluate the value of mean corpuscular volume (MCV), red cell distribution width (RDW) and erythrocyte fragility in the diagnosis of neonatal thalassemia.Methods A total of 386 hospitalized newborns with hyperbilirubinemia were enrolled in this study. They were divided into two groups: Thalassemia group (n= 35)and Non-thalassemia group(n=351) according to the results of thalassemia gene diagnosis. MCV, erythrocyte fragility and RDV were detected. Their ROC curves were made to calculate the areas under ROC (AUC ROC), the cut-offs,sensitivity and specificity of each marker in the diagnosis of thalassemia.Results Both MCV and erythrocyte fragility were significantly lower in the Thalassemia group than in the Non-thalassemia group (80±8 fL vs 94±9 fL, 31%±13% vs 46%±14%,P< 0.01). No differences were observed between the two groups for RDW. AUC ROCs of MCV, RDW and erythrocyte fragility in the diagnosis of thalassemia were 0.877, 0.630 and 0.796, respectively. The cut-offs of MCV, RDW and erythrocyte fragility was 88 fL, 15.9%, and 37.5%, respectively. The sensitivity and specificity of MCV were 92% and 73.5%, respectively, 73% and 58% for RDW and 85% and 75% for erythrocyte fragility. Conclusions Both MCV and erythrocyte fragility can serve as markers for the diagnosis of neonatal thalassemia, and MCV appears to be a better one.

Objective To investigate the situation of human parvovirus B19 infection in children with various diseases in Xinjiang Province,PRC.Methods A total of 81 hospitalized children [18 cases of Henoch-Schoenlein purpura, 17 aplastic anemia (AA), 16 myocarditis, 9 idiopathic thrombocytopenic purpura (ITP), 8 acute lymphocytic leukemia, 8 respiratory infection and 5 nervous system diseases] in the First Affiliated Hospital of Xinjiang Medical University between August 2001 and December 2002 were involved in this study. Enzyme linked immunosorbent assay (ELISA) was employed to detect serum Bl9-IgM and B19-IgG. Serum samples from 16 healthy children were used as the Control group. Results Seven (41.2%) of 17 children with AA and 4 (44.4%) of 9 children with ITP were positive for B19-IgM. The positive rate for B19-IgM of children with either ITP or AA was significantly higher than that of the Control group ( 6.25%, 1/16) (both P<0.05).There were no significant differences in the positive rate for B19-IgM between the rest patients and the Control group.The positive rate for Bl9-lgG in all 81 patients was not different from the Control group.Conclusions The B19 infection rate was higher in children with ITP or AA in Xinjiang region. It is suggested that human parvovirus Bl9 may be closely related to ITP and AA.

Objective Asthma is a chronic non-specific inflammatory of the airways induced by Th2 type cells. IL-12 can inhibit Th2 immune response in the allergen sensitization stage. But whether it can inhibit the established Th2 immune responses is in question. In this study, the effect of IL-12 on the established Th2-type immune responses in asthma was examined in order to provide evidence for the clinical use of IL-12. Methods Experiment 1: Ovalbumin(OVA) and aluminium hydroxide were intraperitonearly injected into 25 female BALB/c mice of 6 - 8 weeks old to induce sensitization. Five mice were sacrificed before sensitization, and a further 5 more were sacrificed on 7, 14, 21 and 28 days after sensitization. The levels of Th2 cytokines IL-4 and IL-5 in the splenic mononuclear cells (MNCs) cultured supernatants were measured using ELISA to evaluate the time of Th2 immune response establishment. Experiment 2: Another 40 female BALB/c mice of 6 - 8 weeks old were sensitized by OVA and aluminium hydroxide intruperitonear injection. Then asthma was induced by OVA inhalation. Twenty asthmatic mice were selected randomly to receive recombinant IL-12 treatment ( 0.5 μg was dissolved in 1 mL PBS once daily for 5 days) from 25 days post-sensitization. The rest of the asthmatic mice (n=20) just received a PBS injection. The 40 asthmatic mice were sacrificed at 30 days post-sensitization. The levels of Th2 cytokines IL-4, IL-5, and Th1 cytokines INF-γ in the splenic MNCs cultured supernatants and in bronchoalveolar lavage fluid (BALF) were measured by ELISA. Results Experiment 1 showed that the concentrations of IL-4 and IL-5 in the splenic MNCs cultured supernatants in mice increased on the 14th day post-injection, which suggested that a Th2 immune response had been established. Experiment 2 showed that the concentrations of IL- 4 and IL-5 in BALF significantly decreased in the IL-12-treated asthmatic mice when compared with the untreated asthmatic mice (19± 5 pg/mL vs 192±19 pg/mL,141±15 pg/mL vs 328±71 pg/mL,P<0.001).The concentration of INF-γ remained unchanged, so the ratio of IL-4/INF-γ in BALF decreased in the IL-12-treated asthmatic mice. The concentrations of IL-4 and IL-5 in the splenic MNCs cultured supernatants were significantly decreased in the IL-12-treated mice (139±54 pg/mL and 98±18 pg/mL) compared with the untreated-asthmatic mice (341±64 pg/mL and 411±108 pg/mL,P< 0.001). In contrast, the INF-γ concentration increased (1 403±185 pg/mL vs 317±55 pg/mL,P< 0.001). Conclusions IL-12 can inhibit established Th2-type immune responses and can restore the Th1/Th2 balance.

Objective To examine the changes of nitric oxide and oxygen free radical in the kidneys of neonatal rats with lung injury induced by prolonged hyperoxia in order to study the induction of renal damage by prolonged hyperoxic exposure. Methods Full-term newborn rats were continuously exposed to oxygen (90%±5% O 2,n=140) or room air (21% O 2,n=88) after birth. Dynamic changes of superoxide dismutase (SOD) activity and content of malondialdehyde (MDA) and nitric oxide (NO) in the lung and kidney were monitered by spectrophotometer on days 1, 3, 7, 14 and 21 in the Hyperoxia and Control group. Results In the Hyperoxia group, SOD activity in lungs began to increase on the 3rd day, and significantly higher than that of controls on the 7th day (214±19 KNU/g vs 186±19 KNU/g, P< 0.01), 14th day (220±15 KNU/g vs 197±21 KNU/g, P< 0.05) and 21th day (251±15 KNU/g vs 195±8 KNU/g, P< 0.01). The MDA level in the lungs increased on the 3rd day ( 28.1± 2.0 μmol/g vs 21.1± 1.3 μmol/g, P< 0.05) and reached a peak on the 7th day ( 30.8± 4.2 μmol/g vs 19.9± 2.2 μmol/g, P< 0.01), then decreased but still remained higher than controls on the 14th day ( 26.3± 3.8 μmol/g vs 22.6± 2.3 μmol/g, P< 0.05). The NO level began to increase and was higher than controls on the 7th day (99±8 μmol/g vs 89±8 μmol/g, P< 0.05), and 14th day (128±34 μmol/g vs 93±17 μmol/g, P< 0.05) and 21st day (171±34 μmol/g vs 106±25 μmol/g, P< 0.01). In the kidney, although there was little difference in SOD activities between two groups, the levels of MDA and NO increased on the 14th day ( 24.1± 5.0 μmol/g vs 16.0± 1.9 μmol/g, P< 0.01; 286±71 μmol/g vs 222±45 μmol/g, P< 0.05), continuously to 21st day ( 16.5± 2.2 μmol/g vs 13.0± 2.7 μmol/g, P< 0.05; 298±65 μmol/g vs 204±49 μmol/g, P< 0.01). These changes appeared later than in the lungs. Conclusions Renal damage can be induced by prolonged hyperoxia exposure and be developed behind lung injury in neonatal rats.