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Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.
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Objective:To investigate the clinical characteristics and prognosis of children with septic shock caused by invasive pneumococcal diseases (IPDs) in pediatric intensive care unit (PICU).Methods:The clinical data of children diagnosed as septic shock caused by IPDs and hospitalized in the intensive care unit (ICU) of Beijing Children′s Hospital, Capital Medical University and the PICU of Henan Children′s Hospital from January 2013 to August 2019 were retrospectively collected, and the clinical characteristics and prognosis of these patients were analyzed.Results:Twenty-one children were included, with a median age of 1.2 (0.75, 3.90) years old.The pediatric index of mortality 2 (PIM-2) at admitting was (23.3±29.6)%, and 6 cases had underlying diseases.Main sites of infection included blood flow (20 cases) and suppurative meningitis (15 cases). The drug sensitivity test was performed on 18 children, among who 9 cases were sensitive to Penicillin, 10 cases to Cefepime, 11 cases to Cefotaxime and 10 cases to Meropenem.All 18 patients were sensitive to Vancomycin and Linezolid.Seven cases and 13 cases were treated with sensitive antibiotics at the disease onset and before septic shock, respectively.In 21 cases whose lactic acid level was (6.1±4.6) mmol/L, the shock redress time of 10 cases was (10.9±10.1)h, and 13 cases (61.9%) died (14.6±12.2) hours after septic shock, among who 10 died of transforamed magna herniation.The PIM-2 score at admitting into PICU and the rate of intracranial hypertension crisis in the death group were significantly higher than those in the survival group [(37.1±30.3)% vs.(0.9±1.3)%, 69.9% (9/13 cases) vs.25.0% (2/8 cases)](all P<0.05). There was no significant difference in age and the utilization rate of effective antibiotics before septic shock between the two groups (all P<0.05). Four of the surviving 8 children had severe cerebral functional disability. Conclusions:Septic shock caused by IPD is more common in children under 5 years old, and the most common sites are blood flow and intracranial infection.It has high resistance rate against Cephalosporins and Carbopenem.Patients with purulent meningitis are easy to develop intracranial hypertension crisis, which has an extremely high mortality and morbidity, so it needs to be identified and treated early.
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Objective:To evaluate the efficacy and safety of nasal continuous positive airway pressure(NCPAP) in the treatment of congenital airway stenosis with severe pneumonia.Methods:A single-center retrospective clinical study was used to select children with congenital airway stenosis and pneumonia who were admitted to PICU of Beijing Children′s Hospital of Capital Medical University during 5 years and treated with NCPAP within 48 hours after admission.The baseline data, clinical manifestations, vital signs, arterial blood gas, clinical outcomes, NCPAP use time and adverse reactions were collected.Results:A total of 64 children were included in this study, with 58 cases in the effective group and six cases in the ineffective group.The total effective rate of NCPAP was 90.6% (58/64) during 5 years.In the effective group, 63.8% patients were weaned in three to seven days, with an average weaning time of 6.09 days.In the effective group, the heart rate and PaCO 2 after NCPAP treatment were significantly lower than that before treatment, and pH and PaO 2 were significantly higher than that before treatment, and the difference was statistically significant (all P<0.05). A total of six patients in the ineffective group were finally changed to tracheal intubation and invasive ventilation.The survival rate of both groups was 100%.All cases had no adverse reactions or complications. Conclusion:NCPAP can effectively improve the oxygenation in children with congenital airway stenosis and severe pneumonia, with high efficiency and good safety.
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Objective@#To evaluate the effect of prophylactic nimodipine in vasospasm prevention and outcome improvement in children with subarachnoid hemorrhage (SAH).@*Methods@#A prospective, randomized controlled clinical trial which enrolled children with SAH who were admitted to pediatric intensive care unit (PICU) of Beijing Children′s Hospital from January 2015 to October 2018 was conducted. A total of 43 patients were randomly divided into nimodipine group (24 patients) and control group (19 patients) according to random number table. Transcranial Doppler (TCD) was used to dynamically monitor blood flow velocity and spectrum monography of bilateral middle cerebral artery (MCA) for vasospasm evaluation. Pediatric cerebral performance category (PCPC) scale was used to evaluate patients′ brain function on 28th day after discharge. Data were analyzed by t test, Mann-Whitney U test, χ2 test.@*Results@#Except heart rate ((157±26) vs. (137±34) beats/min, t=2.079, P=0.045), no significant differences existed between the two groups in basic demographic characteristics, primary diseases, and clinical manifestations (all P>0.05). The peak velocities of bilateral MCA on the 5th day after admission were significantly lower in nimodipine group (left MCA (136±34) vs. (158±23) cm/s, t=-2.890, P=0.006; right MCA (129±34) vs. (176±27) cm/s, t=-3.717, P=0.001). Likewise, a lower peak velocity of left MCA was observed on the 7th day after admission in nimodipine group ((127±45) vs. (152±13) cm/s, t=-2.903, P=0.007), but no significant difference existed in that of right MCA ((131±48) vs. (150±22) cm/s, t=-1.760, P=0.090). Eleven patients suffered from vasospasm, 25% (6/24) in nimodipine group and 26% (5/19) in control group (χ2=0.010, P=1.000), within whom 8 patients had complete remission after continuing nimodipine treatment, one died in hospital and the other two′s vasospasm still existed at the time of discharge. No significant differences were found between the two groups in mean length of hospitalization, proportion of mechanical ventilation, Glasgow coma scale at discharge, survival rate at discharge or survival rate on 28th day after discharge (all P>0.05). However, nimodipine group had a higher proportion of favorable PCPC brain function (92% (22/24) vs. 63% (12/19), χ2=5.208, P=0.030). No side effects such as hypotension, rash or injection site erythema were observed.@*Conclusion@#Prophylactic nimodipine cannot reduce vasospasm incidence in children with SAH but may improve short-term brain function, without any significant safety issues.
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Objective To analyze the clinical characteristics of fatal cases with confirmed influenza A ( H1N1) in children in order to improve the diagnosis and treatment. Methods The fatal cases of influenza A (H1N1) admitted to Pediatric Intensive Care Unit of Beijing Children′s Hospital from December 2017 to March 2018 were collected,whose clinical features,diagnosis,treatment,and the causes of death were ana-lyzed retrospectively. Results A total of eight children were enrolled. The age ranged from 3 months to 9 years,and six cases were less than 5 years old. Four cases had underlying diseases. All patients had fever, cough,dyspnea,cyanosis,flaring nares and three depressions sign. Four cases had coma. On admission,the average score of pediatric index of mortality was 58. 8％. Blood routine test showed that lymphocyte predomi-nance in six cases, three cases had leukopenia. C-reactive protein elevated in five patients. Procalcitonin increased in all cases. P/F ratio (PaO2/FiO2) were less than 100 mmHg(1 mmHg =0. 133 kPa) in four cases who were diagnosed as severe acute respiratory distress syndrome. The pulmonary imaging showed mul-tiple parenchymal or mixed lesions. Three cases had air leakage syndrome,and one had pleural effusion. Bac-terial culture was performed on the day of admission. Four cases were complicated with bacterial infection. Three cases had Gram-positive cocci infection,and multidrug-resistant bacteria were predominant. The aver-age time from onset to definitive diagnosis was 8 days. Neuraminidase inhibitors were used in all patients,and the average time from onset to the first dose was 8 days. Mechanical ventilation were performed in all patients in this group. Extracorporeal membrane oxygenation was applied in one case. Four cases in this group died of severe acute respiratory distress syndrome. Three cases died of influenza associated encephalopathy,and one died of septic shock with multiple organ failure. Conclusion Fatal influenza A (H1N1) mostly appeares in children under 5 years old or with underlying diseases. Acute respiratory distress syndrome and influenza associ-ated encephalopathy are the main causes of death. Delayed diagnosis and delayed use of anti-influenza drugs may be an important factors leading to death,and bacteria infection may be another important cause of death.
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Objective To analyze the cause of fatal cases in children with confirmed influenza virus infection,and in order to improve the level of diagnosis and treatment.Methods Deaths in critical illness of influenza were collected from November 2017 to April 2018 in Pediatric Intensive Care Unit of Beijing Children's Hospital,Capital Medical University.The clinical characteristics and causes of death were retrospectively analyzed according to the different virus types.Results A total of 19 cases were included.Fifteen cases (78.95％) were less than 5 years old and 9 cases (47.37％) were less than 2 years old.On admission,the median score of pediatric index of mortality 2 was 72.7％.There were 11 cases of influenza H1N1 and 8 cases of influenza B.Six cases had underlying diseases.All patients had fever,cough and dyspnea.Thirteen patients had coma.Seventeen cases had pneumonia,11 cases had severe acute respiratory distress syndrome(ARDS),3 cases had air leakage syndrome and 8 cases had influenza-related encephalopathy(IAE).Ten cases (52.63％) died of severe ARDS,7 cases (36.84％) died of IAE,1 case(5.26％) died of multiple organ dysfunction,and 1 case(5.26％)died of severe myocarditis and cardiogenic shock.There was statistical difference in the time from onset to death between the ARDS group and IAE group[15(4,22) d vs.3(2,8) d] (Z =-2.063,P =0.039).Among the children who died of severe ARDS,most patients in influenza H1 N1 group ＜ 2 years old,while those influenza B group ≥ 2 years old.All children who died of IAE were all ≥ 1 years old.Six cases (31.58％) had bacterial infection,mainly gram-positive cocci.All patients were treated with neuraminidase inhibitors.The average time from onset to the first time of medication was 5 days.Conclusions Severe ARDS and IAE are the main causes of death in children with influenza virus infection.Compared with ARDS,the condition of children with IAE worsened more rapidly.
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Objective To analyze the causes of unplanned tracheal extubation in mechanically ventilated patients in the pediatric intensive care unit using quality management practices and observe the changes of extubation rates before and after implementing these practices.Methods In the first place,we set up quality management group in June 2014.Second,the team formulated a risk factor checklist for unplanned tracheal extubation based on literature research, and analyzed the main causes requiring tracheal extubation. The last time,we developed some management measures for important reasons in 2014,and established and implemented a quality management strategy between 2015 and 2016.The incidence frequency of unplanned tracheal extubation,i. e. the number of extubation cases per 100 days with a tube in place(mechanical ventilation days),was used to evaluate the change of the extubation rates before and after implementing the new measures. The cases in 2014 were retrospectively analyzed,and cases from 2015 to 2016 were prospectively collected.The number of interval days for two continuity unplanned extubation was considered to be a means of quality control.Results Rick factors associated with unplanned extubation in the pediatric intensive care unit before implementing quality management were a delay of the replacing adhesive bandage, lack of sedation assessment,which were related to frequent physician replacement and insufficient training and supervision.In consideration of the identified risk factors,a standard operating procedure was formulated to prevent unplanned extubation,including standard operating procedure of tracheal catheter fixation and the sedation assessment. There were 484 mechanical ventilation in 2014,and the incidence of unplanned extubation was 0.8%,and the median number of days of separation was 8.0(4,20) d.Between 2015 and 2016,there were 1 379 mechanical ventilations,and the incidence of unplanned extubation was 0.2%,and the median number of days of separation was 34.0(19,61) d.The incidence of unplanned extubation in 2015 to 2016 was lower than that in 2014(χ2=5.936,P=0.018).Ramsay scoring usage increased from 28.6% in 2014 to 57.1% between 2015 and 2016,while Ramsay scored 3-4 points from 2015 to 2016 was higher than 2014(P< 0.05).Conclusion Establishing the quality management group according to the requirements of each hospital and implementing quality management strategies can reduce the incidence of unplanned extubation,thereby improving the quality of care in pediatric intensive care unit.
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Molecular adsorbent recirculating system is a new artificial liver support system. It consists of blood circulation,albumin regeneration cycle and dialysis circulation circuites. It mainly replaces liver de-toxification function,removes endogenous and exogenous toxins,and regulates water and electrolyte and acid-base balance. The internal environment promotes hepatocyte regeneration. It can be used in the treatment of a-cute liver failure,acute-on-chronic liver failure,and poisoning. Molecular adsorbent recirculating system pro-vides time for recovery of liver function or a bridge for liver transplantation.
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Pulmonary surfactant is a complex mixture of lipoproteins synthesized,secreted and recy-cled by type Ⅱ alveolar cells. The primary function of PS is to minimize the surface tension at the alveolar air-liquid interface. Surfactant dysfunction with quantitative and qualitative abnormalities of both phospholipids and proteins are characteristics of patients with acute respiratory distress syndrome ( ARDS ) . Exogenous surfactant replacement shows consistent improvements in gas exchange,but had limited success in improving survival. These may be due to variety of aetiologies in ARDS、surfactant compositiones, delivery methods, optimal time and doses. At this time,surfactant therapy cannot be recommended as routine therapy in pediatric ARDS.
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Objective To investigate the prognostic factors of pediatric acute respiratory distress syndrome(pARDS),according to pARDS criteria from the 2015 Pediatric Acute Lung Injury Consensus Con-ference.Methods Clinical data of 69 cases with pARDS in PICU of Beijing Children′s Hospital affiliated to Capital Medical University from January 2009 to December 2015 were retrospectively analyzed. Results Among the 69 cases of pARDS,there were 13 cases with mild ARDS,19 cases with moderate ARDS and 37 cases with severe ARDS. Seventeen pARDS were dead in PICU,including 2 mild pARDS,3 moderate pARDS and 12 severe pARDS,and 14 pARDS of them were female,3 pARDS were male.Gender and chron-ic complication were related to the outcomes of pARDS,and the difference was significant(P<0.05).The mortality of pARDS with chronic complication was up to 69.23%.Duration of mechanical ventilation was related to PICU hospital stay and total length of hospital stay(correlation:0.324,0.181,P<0.01).Duration of mechanical ventilation was also related to weight(correlation 0.491,P<0.01),and weight was a protec-tive factor.Conclusion pARDS is one of the most critical diseases in PICU with low morbidity and high mortality,the mortality of pARDS in this study is 24.64%.Female or chronic co-morbidities pARDS may have poor prognosis.Duration of mechanical ventilation determines the PICU length of stay and total hospital length of stay,and weight is the protective factor of the duration of mechanical ventilation.
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Objective To analyze the epidemiologic characteristics and risk factors for mortality in non-(human immunodeficiency virus,HIV) infected children with pneumocystis carinii pneumonia(PCP). Methods The data of non-HIV infected children with PCP diagnosed in Beijing Children′s Hospital from January 1,2006 to December 31,2012 were collected. They were divided into survival and non-survival group according to the prognosis. The epidemiologic characteristics and risk factors for mortality were analyzed. Results Sixteen patients were enrolled in this study. Ten of them survived and 6 of them were non-survived. The basic diseases included malignant tumor in 5 patients and non-malignancy diseases in 11 of them. Com-pared with the survival group,the non-survival group had a higher average age [(12. 00 ± 2. 00) years vs. (6. 65 ± 4. 32)years,P=0. 01],higher ratio to need mechanical ventilation (6/6 vs. 4/10,P=0. 04),lower PaO2/FiO2[(73. 88 ±26. 95) mmHg vs. (167. 50 ± 97. 17) mmHg,1 mmHg=0. 133 kPa,P=0. 01] and lower pediatric critical illness score(75. 67 ± 5. 72 vs. 86. 40 ± 8. 88,P=0. 02). There were no differences on sex ratio,kinds of basic diseases,whether with co-infections,the time of immunosuppressant administration, the time from onset to diagnosis,the time from onset to beginning trimethoprim-sulfamethoxazole therapy, PaCO2 ,white blood cell counts,lymphocyte counts,CD4+ cell counts,C-reactive protein,and hemoglobin con-centrations between the survival and non-survival group. Conclusion A higher age, need for mechanical ventilation,lower PaO2/FiO2 and lower pediatric critical illness score were risk factors for mortality in non-HIV infected children with PCP.
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Objective To investigate the incidence,etiology and risk factors of cardiorespiratory arrest (CRA) in pediatric emergency room and preliminarily evaluate the efficacy of cardiopulmonary resuscitation (CPR).Methods The unified,standard in-hospital Utstein style was used for data collection with filling answers in the questionnaire.The survey items included the causes of cardiorespiratory arrest and the factors influencing the efficacy of CPR.The restoration of spontaneous circulation (ROSC) was used to evaluate short-term efficacy of CPR.Results Totally 182 380 patients aged from 28 days to 18 years were admitted to emergency room of Beijing Children' s Hospital between July 1,2008 and February 28,2010.Of them,237 patients (0.13％) were subjected to cardiorespiratory arrest,of which 169 patients received CPR and 88 patients (52.1％) got sustained ROSC.Neither sex nor age distribution affected ROSC.The primary cause of CRA and kind of initial abnormal rhythm of heartbeat leading to CRA were associated with the rate of ROSC.The rates of ROSC occurred in patients with or without pre-hospital transport were 64.1％ and 44.8％,respectively.The rate of ROSC was closely related to time consumed for getting ROSC by CPR,and as CPR durations were ≤ 10 min,10 to 30 min,and ＞ 30 min,the rates of ROSC were 67.5％,61.4％ and 30.5％,respectively.Multiple stepwise logistic regression analysis showed that kind of initial abnormal rhythm and CPR duration were associated with the rate of ROSC.Conclusions The incidence of CRA in emergency was 0.13％,and the rate of ROSC after CPR was 52.1％.The kind of initial abnormal rhythm of heartbeat and CPR duration were independent factors associated with the rate of ROSC.
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Objective To study the clinical features of invasive pneumococcus disease (IPD) with resistance to antimicrobial agents in children,and to improve the diagnosis and treatment of this disease.Methods The clinical data from 21 IPD patients younger than 13 years old were collected from January 2008 through December 2010 in Pediatric Intensive Care Unit in Beijing Children's Hospital for retrospective analysis. Specimens of blood,pleural effusion,cerebrospinal fluid and soft tissue aspirated were collected from these children,and 23 strains of streptococcus pneumonia (SP) were cultured,isolated and confirmed,and the antibiotics susceptibility to penicillin and other antibiotics of these strains were assayed.Results Among the 21 IPD children,the ratio of male to female was 0.9∶1,and the age was 5 months to 13 years,with 61.9％ of them under 2 years.Of them,12 patients (57.1％ ) had purulent pleurisy,and 1 (4.8％ )patient had an underlying disease diagnosed to be X - linked agammaglobulinemia (XLA).There was no seasonal difference in the occurrence rate of this disease. Eight (38.1％) patients were cured,11(52.4％ ) were improved,while 2 (9.5％ ) patients not improved without death.There was no statistically significant difference in the annual detection rate of invasive SP (x2 =3.711,P =0.156).The incidences of penicillin-intermediate susceptibility SP (PISP) and penicillin-resistant SP (PRSP) were 47.8％ and 26.1％ respectively.The rate of resistance to multiple antibiotics was 91.3％.Conclusions Children aged less than 5 years,especially younger than 2 years,are prone to IPD,and purulent pleurisy and septicemia are often seen in this disease. Some patients had the underlying diseases.The complications included hemophagocytic syndrome,acute respiratory distress syndrome,septic shock,bronchial pleural fistula and so on.The multidrug resistance rate was 91.3％.It is important to put great emphasis on the monitoring antibiotics resistance to invasive pneumococcal disease.
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ObjectiveTo assess the effects of dopamine,dobutamine and norepinephrine on the P(g-a)CO2 and superior mesenteric blood flow in septic shock.MethodsRabbit septic shock model was established by challenging with intravenous injection of lipopolysaccharides from Escherichia coil(2 mg/kg).The rabbits with septic shock were randomly assigned to 3 groups-dopamine group(n = 8),dobutamine group(n = 8) and norepinephrine group(n = 8).Apart from volume resuscitation with normal saline solution [20 ml/(kg· h)]，dopamine[5μg/(kg·min)],dobutamine[(5μg/(kg·min)]and norepinephrine [(1μg/(kg·min)]were infused in dopamine group,dobutamine group and norepinephrine group respeclively.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowrneter.Gastric mucosal PCO2 was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analyses and lactate levels were measured every 1 h.ResultsMAP,CI,and SMBFI significandy decreased and P(g-a) CO2 increased after lipopolysaccharides infusion in three groups.After 2-hour treatment,MAP in norepinephrine group[(70 +3) mm Hg]was higher than that of dopamine group[(66±4) mm Hg]and dobutamine group[(65±4) mm Hg](P ＜0.05).SMBFI in norepinephrine group [(18.7±2.9) ml/(kg·min)]was higher than that of dopamine group[(16.2±1.6) ml/(kg·min)]and dobutamine group[(15.8±1.9) ml/(kg·min)](P＜0.05).P(g-a) CO2 in norepinephrine group [(30±6) mm Hg]was lower than that of dobutamine group[(23±5)mm Hg](P＜0.05).Condnsion As an adjuvant therapy of volume resuscitation,norepinephrine is more effective than low dose dopamine and dobutamine in improving splanchnic perfusion.
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Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis were the main features of NPE.The main approaches to the treatment were mechanical ventilation,mannitol,methylpredifiselone,intravenous immunoglobulin(IVIG),and vasoactive a-gents.And nine patients(25%)needed fluid volume resuscitation in addition.Conclusions Young children are particularly vulnerable to the Severe EV71 encephalitis with NPE.The majority of involved fatal patients are aged under 3 years.Patients may die of acute onset of NPE and/or hemoptysis with rapid progress towards cardiopul-monary failure.Early diagnosis and evaluation,respiratory support,lowering intracranial pressure and maintaining hemodynamics ale the essential therapeutic approaches.
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Objective To investigate the effects of low-dose hydrocortisone on brain dysfunction in LPS-induced sepsis rats and the role of nuclear factor kappa B (NF-?B) signal transcription pathway in the pathogenesis. Methods Fifty-four rats were randomly divided into 3 groups: control group (A group, n=6), model group (B group, n=24), low-dose HC treatment group(C group, n=24). The septic rat model was established by intra-peritoneal injection of LPS (1 mg/kg), the intervention was by caudal vein injection of low-dose HC (6 mg/kg), each of B and C group was subdivided into 2,8,16,24 hours after LPS injection (n=6).At serial time points,the animals in each group were sacrificed , brain tissue samples were harvested to determine NF-?B,I?B expression in hippocampus by immunohistochemistry. Also, the changes of behaviors were observed and the histopathological changes were investigated by Nissl stain.Results In model group (B group): lethargy, anorexia, tachypnea, piloerection, loss of body weight were all more obvious than control groups.Nissl stain showed significant histopathological changes; NF-?B expression was up regulated compared with control group(P