The Structure and Function of Glial Networks: Beyond the Neuronal Connections / 神经科学通报·英文版

Glial cells, consisting of astrocytes, oligodendrocyte lineage cells, and microglia, account for >50% of the total number of cells in the mammalian brain. They play key roles in the modulation of various brain activities under physiological and pathological conditions. Although the typical morphological features and characteristic functions of these cells are well described, the organization of interconnections of the different glial cell populations and their impact on the healthy and diseased brain is not completely understood. Understanding these processes remains a profound challenge. Accumulating evidence suggests that glial cells can form highly complex interconnections with each other. The astroglial network has been well described. Oligodendrocytes and microglia may also contribute to the formation of glial networks under various circumstances. In this review, we discuss the structure and function of glial networks and their pathological relevance to central nervous system diseases. We also highlight opportunities for future research on the glial connectome.

Serum lipoprotein-associated phospholipase A2 level is positively correlated with the recurrence risk of acute ischemic cerebral infarction in hypertensive patients / 南方医科大学学报

OBJECTIVE@#To explore the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the risk of acute ischemic stroke (AIS) recurrence in hypertensive patients.@*METHODS@#This retrospective case-control study was conducted among 211 hypertensive patients with AIS treated in Foshan First People's Hospital, including 35 patients with recurrence of AIS during the 1-year follow-up as confirmed by head CT/MR. In the overall patients, 60 had grade 1 hypertension (including 5 recurrent cases), 76 had grade 2 hypertension (with 11 recurrent cases), and 75 had grade 3 hypertension (with 19 recurrent cases). Univariate analysis, multivariate logistic regression analysis, trend analysis, and smooth curve fitting analysis were performed to explore the correlation between serum Lp-PLA2 level within 24 h after admission and the risk of AIS recurrence. The predictive efficacy of serum Lp-PLA2 level for AIS recurrence in different hypertension grades was evaluated using ROC curve analysis.@*RESULTS@#Serum Lp-PLA2 level, age, NIHSS score at admission, mRS scores at 7 days, homocysteine level and smoking status differed significantly between patients with and without AIS recurrence (P < 0.05). After adjustment for confounding factors, multivariate regression analysis showed that the highest tertile of Lp-PLA2 level was associated with a 4.13-fold increase of AIS recurrence risk compared with the lowest tertile (OR=5.13, 95% CI: 1.35-19.40), and each 1 ng/mL increase of Lp-PLA2 level was associated with a 1% increase of AIS recurrence risk (OR= 1.01, 95% CI: 1.01-1.02). Serum Lp-PLA2 level was shown to positively correlate with AIS recurrence risk, and in patients with grade 3 hypertension, its areas under the ROC curve for predicting AIS recurrence was 0.869 with a specificity of 0.893 and a sensitivity of 0.737.@*CONCLUSION@#Serum Lp-PLA2 concentration is an independent risk factor and potentially an effective predictor for AIS recurrence in patients with grade 3 hypertension.

Braided stent-assisted coil embolization versus laser engraved stent-assisted coil embolization in patients with unruptured complex intracranial aneurysms

Abstract Purposes: Braided and laser-cut stents both are efficacious and safe for coiling intracranial aneurysms. The study aimed to compare outcomes following braided stent-assisted coil embolization versus laser engraved stent-assisted coil embolization in 266 patients who were diagnosed with unruptured intracranial aneurysms of different types and locations. Methods: Patients with unruptured complex intracranial aneurysms underwent braided (BSE cohort, n = 125) or laser engraved (LSE cohort, n = 141) stent-assisted embolization. Results: The deployment success rate was higher for patients of the LSE cohort than those of the BSE cohort (140 [99%] vs. 117 [94%], p = 0.0142). Seventy-one (fifty-seven percentages) and 73 (52%) were coil embolization procedure success rates of the BSE and the LSE cohorts. Periprocedural intracranial hemorrhage was higher in patients of the BSE cohort than those of the LSE cohort (8 [6%] vs. 1 [1%], p = 0.0142). Four (three percentages) patients from the LSE cohort and 3 (2%) patients from the BSE cohort had in-stent thrombosis during embolization. Permanent morbidities were higher in patients of the LSE cohort than those of the BSE cohort (8 [6%] vs. 1 [1%], p = 0.0389). Higher successful procedures (76% vs. 68%) and fewer postprocedural intracranial hemorrhage (0% vs. 5%) and mortality (0% vs. 5%) were reported for patients of the BSE cohort in posterior circulation aneurysmal location than those of the LSE cohort. Laser engraved stent has fewer problems with deployment and may have better periprocedural and follow-up outcomes after embolization. Conclusions: Braided stent-assisted embolization should be preferred when the aneurysm is present in the posterior circulation.

Clinical and genetic analysis of a pedigree with Wolfram syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical features and genetic background of autosomal recessive Wolfram syndrome caused by WFS1 gene mutation.METHODS: A pedigree with autosomal recessive Wolfram syndrome was studied by clinical examination, gene analysis and bioinformatics.RESULT: It was found that the proband and his brother had diabetes, color weakness and optic neuropathy. In addition, his brother had diabetes insipidus. Whole-exome sequencing(WES)analysis showed that there were two heterozygous variations in the WFS1 gene exon 8 of the two brothers: c.941G&#x0026;#x003E;A(p.W314X)and c.2309T&#x0026;#x003E;G(p.F770C), and were co-separated from the clinical phenotype in this family.CONCLUSION: The compound heterozygous mutation of WFS1 gene is associated with Wolfram syndrome in this pedigree. Among them, c.941G&#x0026;#x003E;A(p.W314X)has not been reported yet.

Correlation analysis of Trial of Org 10172 in acute stroke treatment classification and National Institutes of Health Stroke Scale score in acute cerebral infarction with risk factors

SUMMARY OBJECTIVE: The aim of this study was to investigate the correlation between the Trial of Org 10172 in acute stroke treatment classification and the National Institutes of Health Stroke Scale score of acute cerebral infarction as well as acute cerebral infarction's risk factors. METHODS: The clinical data of 3,996 patients with acute cerebral infarction hospitalized in Hebei Renqiu Kangjixintu Hospital from January 2014 to November 2018 were analyzed retrospectively. According to Trial of Org 10172 in acute stroke treatment, they were divided into five groups: arteriosclerosis, cardio cerebral embolism, arterial occlusion, other causes, and unknown causes. Through questionnaire design, routine physical examination, and physical and chemical analysis of fasting venous blood samples, the risk factors were evaluated, and the correlation between Trial of Org 10172 in acute stroke treatment classification and National Institutes of Health Stroke Scale classification was analyzed using multivariate logistic regression. In addition, the relationship between National Institutes of Health Stroke Scale score and risk factors in different groups was compared, and the correlation between Trial of Org 10172 in acute stroke treatment classification and National Institutes of Health Stroke Scale score was analyzed. RESULTS: Multivariate logistic regression analysis showed that diabetes, atrial fibrillation or stroke history, age, and education level were related to Trial of Org 10172 in acute stroke treatment classification. In the National Institutes of Health Stroke Scale comparison, the scores of the cardio cerebral embolism group were significantly higher than those of the other four groups, and patients with diabetes, atrial fibrillation, or stroke history had a high share, especially atrial fibrillation (33.06%). CONCLUSIONS: The nerve function defect is more serious after acute cerebral infarction with cardiogenic cerebral embolism, indicating a poor prognosis.

Mental health status of the pupils from Grade Four and Fivein Jiading District / 预防医学

Objective @#To investigate the mental health status of the pupils from Grade Four and Five in Jiading District of Shanghai, and to provide evidence for mental health intervention.@*Methods @# All the students from Grade Four and Five in Jiading District, Shanghai were selected as survey objects. The MHT was used to evaluate their mental health status, and the influencing factors of mental health problems were analyzed by multivariate logistic regression model.@*Results @#A total of 3 788 questionnaires were issued, of which 3 100 ones were valid and the effective rate was 81.84%. The detection rate of mental health problems was 17.06%. The detection rates of impulse tendency, terror tendency, physical symptoms, sensitivity tendency, self-blame tendency, loneliness tendency, anxiety towards people and learning anxiety were 11.77%, 15.55%, 12.97%, 16.19%, 10.10%, 4.81%, 13.16% and 14.00%, respectively. The results of multivariate logistic regression analysis showed that female students ( OR=1.617,95%CI: 1.325-1.974 ) , poor self-rated appearance ( OR=3.683, 95%CI: 2.428-5.586 ) ,only one or two friends ( OR=1.806, 95%CI: 1.342-2.428 ) , poor academic performance ( OR=1.626, 95%CI: 1.167-2.267 ) , primary school education or below of mother ( OR=1.539, 95%CI: 1.107-2.139 ) general or poor relationship with mother ( OR=1.785, 95%CI: 1.303-2.444 ) or father ( OR=1.745, 95%CI: 1.336-2.280 ) were risk factors for mental health problems. @*Conclusion @#The fourth-to fifth-grade primary school students in Jiading District of Shanghai have high detection rate of psychological problems. Gender, the number of friends, academic performance, education level of mother and the relation with parents are associated.

Perceptions, Attitudes, And Responses To Dengue Early Warning Among Urban Community In Kuala Lumpur

@#Dengue early warning system, based on many different factors including climatic factors, is likely to be a useful tool for predicting dengue cases. This study aims to assess the perceptions, attitudes, and responses to dengue early warning among a sample of residents in Kuala Lumpur, Malaysia as well as the factors associated with their willingness in participating dengue prevention public activity. A community-based cross-sectional study was conducted among residents of Titiwangsa District, Kuala Lumpur. A structured questionnaire was administered via face-to-face interview. About 75% of the respondents perceived dengue early warning as a useful tool for the community to take preventive measures. However, more than half did not know elevated temperature increases dengue cases. More than 80% wanted to know more how climate can be used to predict dengue outbreak. Willingness of participating in dengue control public activity was associated with age (p<0.001), educational level (p=0.005), perception (p<0.001), and attitude (p<0.001). Perception towards dengue early warning was positive among the urban residents. Majority of the participants reported good attitude with regard to dengue early warning while a minority demonstrated a poor response. Educational level, perception, and attitude are significantly associated with willingness to engage in dengue prevention public activity.

Utility of single fiber electromyography in the differential diagnosis of hyperthyroidism associated with ocular myasthenia gravis and Graves ophthalmopathy / 临床神经病学杂志

Objective To assess the utility of single fiber EMG (SFEMG)in the differential diagnosis of hyperthyroidism associated with ocular myasthenia gravis (OMG)and Graves ophthalmopathy.Methods SFEMG was performed in orbicularis oculi muscle of 2 groups of patients.including 32 patients with hyperthyroidism associated with OMG,and 35 patients with Graves ophthalmopathy.The parameters of SFEMG between different groups were compared.Results The mean jitter was (96.2 ± 23.7),(42.8 ± 12.6)μs in hyperthyroidism associated with OMG and patients with Graves Orbitopathy. M50of the percentage of jitter ＞55 μs was 92% and 5% in the 2 groups respectively.M50of the percentage of block was 25% and 0 in the 2 groups respectively.Fiber density was (1.9 ± 0.4)and (1.7 ± 0.5)in the 2 groups respectively.There was significant difference in those parameters of SFEMG between the patients in 2 groups(t＝15.56,Z＝9.26,Z＝7.35,all P＜0.01).Conclusion SFEMG of orbicularis oculi muscle shows significantly increased jitter and block in hyperthyroidism associated with OMG,which can help to differentiate hyperthyroidism associated with OMG from Graves ophthalmopathy.

Effect of regulating platelet function on systemic inflammatory response and pul-monary oxygenation function in rats during extracorporeal circulation / 中国免疫学杂志

Objective:To investigate the effect of regulating platelet function on systemic inflammatory response and pulmonary oxygenation function in rats during extracorporeal circulation(ECC).Methods:The rats participating in the ECC model were randomly divided into ECC supplemented platelet group (group MH),ECC supplemented plasma group (group MP),and continuous pump Tirofiban+ECC supplemented platelet group (group TMH),with 8 rats in each group.Rats of the three groups lasted two hours with ECC,observed for two hours after operation.Enzyme linked immunosorbent assay (ELISA) was used to detect inflammatory factors in the plasma and bronchoalveolar lavage fluid of rats in the three groups.The oxygenation index and lung tissue water content were meas-ured.The number of circulating endothelial quantity was measured by flow cytometry,and pathological changes of lung tissue in rats were observed by hematoxylin eosin staining.The effects of regulating platelet function on the levels of systemic inflammatory response, the degree of vascular endothelial damage,the edema degree of lung tissue and pulmonary oxygenation function of ECC rats were analyzed.Results:There was no significant difference in platelet count between group MH and group MP after two hours with ECC(P>0.05),the group TMH was significantly higher than that in group MH and group MP (P<0.05).After two hours with ECC,the oxygenation indexes of the three groups were lower than that at the beginning of ECC(P<0.05).There was no significant difference in lung tissue water content between the three groups(P>0.05);the level of neutrophil elastase(NE) in bronchoalveolar lavage fluid of rats in group MH was lower than that in group TMH(P<0.05),the level of NE in plasma of group TMH was lower than that in group MP (P<0.05).At the end of ECC,there were no statistically significant differences in circulating endothelial quantity of the three groups (P>0.05).Pathological examination of lung tissue showed that the lung interstitium of group MH was thinner than that of other groups,and inflammatory cell infiltration was less.Conclusion:At the early stage of ECC,supplement fresh platelets after platelet sharp decrease can significantly reduce the inflammatory response in the circulation.The protective effect may be related to platelets adhere to the endothelium associated with ECC related inflammatory reactions,and decrease the neutrophils and endothelial tissue adhesion.It is suggested that certain number of platelets with normal adhesion and aggregation function in ECC may reduce inflammatory response and lung injury after operative,and improve prognosis.

Influence of staring at mobile phone on static balance, plantar pressure gait characteristics and lower limb joints in young men / 中国组织工程研究

BACKGROUND:Smartphones are a double-edged sword,which not only bring convenience,but also result in excessive reliance.Especially the youth often gaze at their phones when standing or walking,which may affect their static standing balance and plantar pressure gait characteristics.OBJECTIVE:To investigate the influence of staring at mobile phones when standing or walking on the static balance,plantar pressure and gait characteristics in young men,thus informing its negative effect on gait characteristics and lower limb joints.METHODS:Twenty health young men were selected,the plantar pressure when normal standing and walking was measured using Loran plantar pressure analysis system (NO.MPS,Italy).After 20 minutes of rest,the same measurement was performed in all participants staring at mobile for 10 minutes during standing or walking.The relative indexes were compared between two conditions after data collection.RESULTS AND CONCLUSION:When young men staring at mobile phone for 20 seconds during standing,the fluctuation speed,displacement and track area were significantly larger than those during normal standing (P ＜ 0.05);moreover,the contact area,pressure peak and average pressure of the first and second metatarsus in plantar area were significantly larger than those during normal standing (P ＜ 0.05),while the parameters of heel lateral area were significantly lower than those during normal standing (P ＜ 0.05).The stride and speed when staring at mobile phone during walking were significantly smaller than those during normal walking (P ＜ 0.05);the support time of two feet and angle between feet were significantly larger than those during normal walking;the contact area,pressure peak and average pressure of the 4th and 5th metatarsus in plantar area and heel lateral area were significantly larger than those during normal walking.These results suggest that the gravity is less stable and more anterior when young men staring at mobile phone during standing than during normal standing.Staring at mobile phone during walking can alter the gait characteristics,resulting in longer support time,shorter stride,slower step speed,larger walking angle and higher lateral plantar pressure.

Residue Analysis of SIOC0426 in Environmental Samples and Its Degradation in Soil / 分析化学

An analytical method based on ultra performance liquid chromatography-tandem mass spectrometry was developed for the determination of SIOC0426 residues in environment samples ( soil, sediment and water) . The fate of SIOC0426 in three kinds of soils was also evaluated. The target compound was extracted with acetonitrile, cleaned up by C18 cartridge, and analyzed by gradient ultra performance liquid chromatography-tandem mass spectrometry with electrospray ionization under positive mode ( ESI+) using a UPLC BEH C18 column. The method was validated using fortified soil, sediment and water. Mean recoveries of SIOC0426 at three spiked levels ( 0 . 005 , 0 . 05 and 2 . 0 mg/kg ) ranged from 87% to 106% with relative standard deviations of 2. 8%-8. 0%. Limits of quantification ( LOQs) of SIOC0426 in soil ( sediment) and water were 0. 2 μg/kg and 0. 2 μg/L, respectively. Linear calibration functions with correlation coefficients R2>0. 9999 were obtained in the concentration range of 0. 5-20 μg/L. This method was applied to the analysis of SIOC0426 residues in soil degradation samples. The results showed that the half-life of SIOC0426 ranged from 1. 72 days to 28. 2 days in three kinds of soils under aerobiotic conditions. While, the half-life of SIOC0426 ranged from 2. 93 days to 31. 4 days in three kinds of soils under anaerobic conditions. The degradation speed of SIOC0426 under aerobiotic conditions was faster than that under anaerobic conditions in the same soil. And the degradation speed of SIOC0426 in soils may be connected with the pH value of soils, cation exchange capacity and soil texture.

Residue Analysis of SIOC0426 in Environmental Samples and Its Degradation in Soil / 分析化学

An analytical method based on ultra performance liquid chromatography-tandem mass spectrometry was developed for the determination of SIOC0426 residues in environment samples ( soil, sediment and water) . The fate of SIOC0426 in three kinds of soils was also evaluated. The target compound was extracted with acetonitrile, cleaned up by C18 cartridge, and analyzed by gradient ultra performance liquid chromatography-tandem mass spectrometry with electrospray ionization under positive mode ( ESI+) using a UPLC BEH C18 column. The method was validated using fortified soil, sediment and water. Mean recoveries of SIOC0426 at three spiked levels ( 0 . 005 , 0 . 05 and 2 . 0 mg/kg ) ranged from 87% to 106% with relative standard deviations of 2. 8%-8. 0%. Limits of quantification ( LOQs) of SIOC0426 in soil ( sediment) and water were 0. 2 μg/kg and 0. 2 μg/L, respectively. Linear calibration functions with correlation coefficients R2>0. 9999 were obtained in the concentration range of 0. 5-20 μg/L. This method was applied to the analysis of SIOC0426 residues in soil degradation samples. The results showed that the half-life of SIOC0426 ranged from 1. 72 days to 28. 2 days in three kinds of soils under aerobiotic conditions. While, the half-life of SIOC0426 ranged from 2. 93 days to 31. 4 days in three kinds of soils under anaerobic conditions. The degradation speed of SIOC0426 under aerobiotic conditions was faster than that under anaerobic conditions in the same soil. And the degradation speed of SIOC0426 in soils may be connected with the pH value of soils, cation exchange capacity and soil texture.

Mechanism of Apoptosis for Resveratrol-mediated Reversing the Drug-resistance of AML HL-60/ADR cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the mechanism of apoptosis for resvertrol-mediated reversing the drug-resistance of AML HL-60/ADR cells.</p><p><b>METHODS</b>The HL-60/ADR cells were divided into 4 groups: control group, adriamycin (ADR)-treated group, resveratrol(Res)-treated group and ADR+Res-treated group. The inhibitory rate of cell proliferation was analyzed by CCK-8 method. The auto-fluorescence intensity of intracellular ADR and the apoptotic rate of HL-60/ADR cells were detected by flow cytometry. The mRNA expression levels of multidrug-resistance associated protein-1(MRP1), anti-apoptotic gene BCL-2 and pro-apoptotic gene BAX were analyzed by real-time fluorescence quantitative RT-PCR. The protein expression levels of MRP1, BCL-2 and BAX were detected by Western blot.</p><p><b>RESULTS</b>The maximal inhibition rates of cell proliferation were 44%, 61%, 76% and 81%, respectively in different concentration of Res (25, 50, 100, 200 µmol/L) and with concentration-dependent manner(r=0.876, P<0.05). Compared with ADR group (IC: 8.534±1.111 µmol/L), the half inhibitory concentration (IC) of HL-60/ADR cells [(1.591±0.373) µmol/L] decreased significantly in ADR+Res group(P<0.05). The auto-fluorescence intensity of ADR in HL-60/ADR cells of ADR+Res group increased significantly (P<0.05). The apoptotic rate of HL-60/ADR cells in Res or ADR+Res group increased significantly (P<0.05). The mRNA expression levels of MRP1 and Bcl-2 in Res or ADR+Res groups decreased and BAX increased significantly (P<0.05). The protein expression levels of MRP1 and BCL-2 were decreased, BAX increased significantly in Res or ADR+Res group (P<0.05).</p><p><b>CONCLUSION</b>Resveratrol shows the effect of reversing the drug resisitance of HL-60/ADR cells in acute myeloid leukemia, possibly via promoting the apoptosis of HL-60/ADR cells and inhibiting the expression of MRP1, which may be related with the inhibition of BCL-2 expression and the promotion of BAX expression.</p>

Role of Pediatric Critical Illness Score in evaluating severity and prognosis of severe hand-foot-mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the role of Pediatric Critical Illness Score (PCIS) in evaluating the prognosis and severity of severe hand-foot-mouth disease (HFMD).</p><p><b>METHODS</b>This study included 424 children with severe HFMD, consisting of 390 survivors and 34 deceased patients. Related physiological parameters and clinical data were collected for calculating PCIS scores. The area under receiver operating characteristic curve (AUC) was employed to assess the performance of PCIS in evaluating the complications and outcomes.</p><p><b>RESULTS</b>The median of PCIS scores for survivors was higher than that for deceased patients (P<0.01). Of the 424 children with severe HFMD, only 26 (6.1%) had critical illness according to the severity assessment using PCIS. The AUC (95%CI) of PCIS was 0.74 (0.66, 0.82) in predicting pulmonary edema, 0.82 (0.74, 0.90) in predicting pulmonary hemorrhage, and 0.83 (0.75, 0.92) in predicting death.</p><p><b>CONCLUSIONS</b>PCIS can predict the complications and prognosis in children with severe HFMD. However, the existing scoring system of PCIS cannot fully assess the severity of HFMD.</p>

Changes of AFP and beta-hCG in testicular tumors analyzed by a function method / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish a new function method for the analysis of a-fetoprotein (AFP) and beta-hCG in testicular tumors.</p><p><b>METHODS</b>We reexamined the serum levels of AFP and beta-hCG after radical orchiectomy, and calculated the measured coordinate, with the abscissa representing the number of the half-lives of tumor markers, and the ordinate representing the measured value of tumor markers. Referring to the measured value of tumor markers before surgery as a, the number of half-lives as x, and their theoretical value over a period of x elimination half-lives as y (logarithm to the base 2 of y), we calculated the predicted coordinate according to the formula y = log2(a/2x) ==> x + y = log2a (function 1). Then we assessed tumor residue and metastasis by analyzing the relationship between the measured and predicted coordinates.</p><p><b>RESULTS</b>The pathological examination of case 1 revealed a germ cell tumor of a mixed histological pattern of syncytiotrophoblast and yolk sac tumor. The measured coordinates of AFP and beta-hCG were (2.22, 6.21) and (10, 8.38), and the predicted coordinates (2.22, 6.34) and (10, 4.41) , indicating the elimination of the yolk sac tumor and metastasis of the syncytiotrophoblast tumor. Case 2 demonstrated the mixed pathological nature of teratocarcinoma and yolk sac tumor. The measured coordinates of AFP and beta-hCG were (2.67, -1.03) and (12, -3.32), and the predicted coordinates (2.67, 1.41) and (12, -5.80). But the review times of AFP and beta-hCG were out of the effective range of half-lives, with the measured values below the normal, which suggested no tumor residue or metastasis. Case 3 was found to be embryonal carcinoma. The measured coordinate of AFP was (0.22, 9.25) , and the predicted coordinate (0.22, 9.55) , indicating the elimination of tumor.</p><p><b>CONCLUSION</b>The change of the tumor markers predicted by the function method coincided with the natural course of disease in the three cases. The coincidence of the measured with the predicted coordinate after radical orchiectomy indicates no metastasis, while their disagreement suggests possible residue and metastasis of the tumor.</p>

Influencing factors on underweight and stunting among children aged 0-3 years in rural areas from ten provinces in China / 中华流行病学杂志

Objective To analysis the influencing factors on underweight and stunting among children aged 0-3 years in rural areas from ten provinces in China.Methods Children under study were identified by multi-stage stratified cluster from rural areas of ten provinces in China.The ascertainment methods mainly included questionnaire and anthropometric measurements.Results There were 58 926 children under investigation,with 50.91％ were boys.The overall rates on underweight and stunting were 5.05％ and 10.49％ respectively.The rate in the 6 month-olds (1.97％,3.79％ ) was the lowest,while the highest were in the 24 month-olds (7.80％) and the 36 month-olds (16.83％).Age,sex,birth weight,gestational weeks as well as maternal education and fathers' schooling were factors significantly related to childhood underweight and stunting (P＜0.0001).Conclusion The status of underweight and stunting among children aged 0-3 years in rural areas was impressive,with birth weight was the key factor influencing the growth of children.Perinatal health care should be improved to promote the growth of children.

Comparison the therapeutic effect of intra-arterial thrombolysis and intravenous thrombolysis for acute ischemic cerebral infarction within 6 hours of onset: A meta-analysis / 中国脑血管病杂志

Objective: To evaluate the efficacy and safety of intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction through a meta-analysis. Methods: The literatures of the randomized controlled trials of using urokinase or recombinant tissue plasminogen activator for intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction from January 1 ,2000 to August 5,2010 were reviewed. The primary outcome measures were the proportions of neurological improvement (basic cure + excellent results) in the intra-arterial thrombolysis and intravenous thrombolysis groups. The secondary outcome measures were the European Stroke Scale (ESS) scores after the treatment and the proportion of symptomatic intracranial hemorrhage. The meta-analysis software, RevMan 4. 2 was applied for pooling the data of all the findings. Two reviewers extracted the data independently. Results: A total of 11 articles either from foreign or domestic sources and 723 patients with acute cerebral infarction were included, in which 305 patients underwent intra-arterial thrombolysis and 418 underwent intravenous thrombolysis. Circled digit oneThe total improvement rate of the intra-arterial thrombolysis was 70. 92% and that of intravenous thrombolysis was 61. 29%. There was significant difference between them (χ2 =4. 895,P 0. 7 ). There was no significant difference in thrombolytic modes in the risk of complicating intracranial hemorrhage between the two groups (OR = 1. 12, 95% CI:0. 63 - 2.01,P = 0.69). Conclusion: The efficacy of intra-arterial thrombolysis for acute cerebral infarction is superior to that of intravenous thrombolysis, and both the incidences of symptomatic intracranial hemorrhage is comparable. A large, high-quality randomized controlled trial is need for further verification.

Clinical and pathologic characteristics of pancreatic necrosis in critically ill children / 世界急诊医学杂志（英文）

@#BACKGROUND: Pancreatic damage in critically ill patients is associated with the progressive failure of multiple organs, but little is known about its clinical characteristics. At present, no guidelines are available for the diagnosis and management of pancreatic damage. This study was undertaken to analyze the clinical and pathologic characteristics of pancreatic necrosis in critically ill children, and to find some biological markers of pancreatic damage or pancreatic necrosis. METHODS: We retrospectively reviewed the clinical data, laboratory results, and autopsy findings of 25 children, who were admitted to Hunan Children's Hospital, China from 2003 to 2009, and died of multiple organ failure. The autopsy revealed pancreatic necrosis in 5 children, in whom sectional or gross autopsy was performed. RESULTS: The 5 children had acute onset and a fever. Two children had abdominal pain and 2 had abdominal bulging, flatulence and gastrointestinal bleeding. Four children had abnormal liver function, characterized by decreased albumin and 3 children had elevated level of C-reactive protein (CRP). B-ultrasonography revealed abnormal acoustic image of the pancreas in all children, and autopsy confirmed pancreatic necrosis, which may be associated with the damage of the adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other organs. Children 1 and 2 died of acute hemorrhagic necrotizing pancreatitis (AHNP);children 3-5 died of multiple organ dysfunction syndrome (MODS) due to pancreatic necrosis. CONCLUSION: Pancreatic damage or pancreatic necrosis in critically ill children is characterized by acute onset, severity, short course, multiple organ damage or failure. It may be asymptomatic in early stage, and easy to be ignored.

Analysis of 13 critically ill children complicated with pancreatic damages / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the pathological reports and clinical data of the cases with pancreatic damage in critically ill children, and summarize the clinical features and biological markers of critically ill children with pancreatic damage or pancreatic necrosis so as to provide the basis for early diagnosis and treatment in children complicated with pancreatic damage.</p><p><b>METHODS</b>The clinical data of 13 patients treated in our hospital from 2003 to 2009 whose autopsy confirmed pancreatic damage existed and the pathological results of all organs were collected and analyzed.</p><p><b>RESULTS</b>All the cases had acute onset; 7 cases had fever, 2 had abdominal pain, the other cases had abdominal distention, hepatosplenomegaly, hypoactive bowel sounds, ascites, intestinal obstruction and gastrointestinal bleeding, etc. All these cases had abnormal liver function, especially elevated ALT or AST level and significantly decreased albumin, 9 cases had abnormal blood glucose, 5 cases had elevated C-reactive protein (CRP). In abdominal B-mode ultrasonography, no case showed abnormal pancreas acoustic image. Autopsy confirmed that 7 cases had varying degrees of necrosis of the pancreas, other 6 cases showed edematous, hemorrhagic or inflammatory changes, which may be associated with adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other damage. All these children died within 36 hours after the patients' conditions worsened.</p><p><b>CONCLUSIONS</b>Pancreatic damage or necrosis in critically ill children had acute and ferocious onset, short course and were prone to multiple organ damage or failure to which all pediatric clinicians should have high alert.</p>

Clinical characteristics of children with acute pancreatitis / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the characteristics of children with acute pancreatitis and provide the basis of early diagnosis and treatment.</p><p><b>METHODS</b>Totally 121 children with acute pancreatitis admitted to Hunan Children's Hospital between March 2003 and December 2009 were enrolled in this retrospective study. The data of clinical manifestations, biochemical examinations, imaging and prognosis were summarized and statistically analyzed.</p><p><b>RESULTS</b>Of the 121 cases, preschool and school-age children were the main groups, and the prevalent months were May and June. Abdominal pain (88.4%) and vomiting (61.2%) were the major initial symptoms of pancreatitis in children, but none of children under the age 1 year complained of abdominal pain; 70.2% had signs of abdominal tenderness, accompanied by abdominal rigidity, distension, hepatomegaly, jaundice, etc. Severe patients developed shock, convulsions, coma and so on. Serum amylase concentration increased to above the upper reference limit in 114 children (94.2%) when they admitted within 24 hours after admission. Urine amylase elevation was noted in 77 children (79.4%). The amylase concentration decreased after 3 days, but not all returned to normal 14 days afterward. Children with sustained serum amylase elevation or serum amylase level ≥ 3 times upper limit of normal range more likely to have fever, vomiting, abdominal distension, and pancreatic abnormalities at ultrasonography or CT which showed that the echo of pancreas decreased or enhanced, pancreas edema, pancreatic duct expanded, etc. Abdominal ultrasonography and CT showed that 75 cases (62.0%) had other organ damage besides pancreatitis, liver (25.3%) and intestinal (16.0%) damages were very common, while liver and myocardial damages were seen frequently in the laboratory examinations, which complicated with serum ALT/AST, total bilirubin, blood glucose elevation and myocardial enzyme abnormalities. Several gastroscopic examinations showed mucosal hyperemia and edema, sheet-like erosion, etc. Except for one case who underwent laparotomy, all the remaining children were treated with non-operative comprehensive treatment. Of them 119 were cured or improved, 2 died and 5 had recurred disease later.</p><p><b>CONCLUSIONS</b>Gastrointestinal symptoms were the main clinical manifestations of acute pancreatitis in children, often complicated with extrapancreatic damage. The younger the patient was, the less complaint of abdominal pain they had. This indicates that acute pancreatitis should be considered when children suffered from acute abdominal pain and vomiting which had no known cause or could not be explained. It is important to do take serial monitoring of serum amylase, and imaging procedures.</p>