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目的检测婴儿痉挛(IS)外周血多药耐药基因1(MDR1)及其产物P-糖蛋白(Pgp)的表达,探讨IS与多药耐药基因的关系。方法 2007年1月至2010年6月徐州医学院附属医院、徐州市儿童医院门诊及病房收治的IS患儿23例,分为2组:治疗前组、治疗超过6个月组。同期选取其他癫痫发作类型组12例、正常对照组10名。采用逆转录聚合酶链反应(RT-PCR)半定量法检测患儿外周血中MDR1基因mRNA的表达,流式细胞术检测患儿外周血Pgp表达。结果小儿外周血MDR1 mRNA与Pgp蛋白表达呈高度正相关(r=0.86,P<0.05)。治疗前组、治疗超过6个月组、其他癫痫发作类型组外周血MDR1 mRNA和Pgp蛋白表达均较正常对照组增高,且治疗前组、治疗超过6个月组MDR1基因mRNA和Pgp蛋白表达水平明显高于其他癫痫发作类型组,差异均有统计学意义(P<0.05,P<0.01)。治疗前组、治疗超过6个月组间MDR1 mRNA和Pgp蛋白表达差异无统计学意义(P>0.05)。结论 IS患儿MDR1和Pgp表达增高可能是临床耐药的重要原因,且可能为内源性耐药。     

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??Objective??To investigate the correlations between plasma monocyte /macrophage chemoattractant protein and related parameters of insulin resisitance in children with simple obesity. Methods??70 children with simple obesity were enrolled as study group??30 healthy children as control group. Body mass index??BMI ??and waist circumference ??WC??were detected as indices of obesity .Plasma levels of macrophage inflammatory protein-1????MIP-1??????monocyte chemoattractant protein-1??MCP-1 ??were measured by ELISA.The rate of CD68 positive cells in blood were detected by flow cytometry??FCM???? Plasma levels of insulin ??adiponectin were measured by RIA?? Insulin resisitance index ??InRI?? were caculated by homeostasis model assessment of insulin resistance ??HOMA-IR??. The associations between MIP-1????MCP-1 levels and adiponectin and related parameters were analyzed with Pearson correlation analysis or partial correlation analysis??Results??The concentration of MIP-1?? and MCP-1 in plasma in children with simple obesity were higher than that in control group. There was a significant difference between the two groups ??P < 0. 05??. The rate of CD68 positive cells in blood of simple obesity had no significant difference between that in control group ??P > 0.05??.The concentration of MIP-1?? and MCP-1 in plasma had positive correlations with BMI and WC and InRI??P < 0. 05??. The concentration of adiponectin in plasma had negetive correlations with BMI and WC and InRI ??P < 0. 05??. The rate of CD68+ cell in blood had no correlation with BMI and WC and InRI??P < 0. 05??.Conclusion??We found that a differential low-grade inflammation is associated with obesity of children .The levels of MIP-1????MCP-1 in blood of obesity were associated with insulin resistance and abdominal obesity. The levels of plasma MIP-1????MCP-1??adiponectin may predict the onset of obesity related complications.     

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目的研究T细胞免疫球蛋白域黏蛋白域蛋白-1(TIM-1)启动子-1454G/A基因多态性与儿童过敏性紫癜(HSP)的相关性,探讨HSP的遗传易感因素。方法2008年3月至2009年2月安徽医科大学第一附属医院、安徽省立儿童医院住院HSP患儿143例,应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析、基因测序等技术测定HSP患儿和178名正常儿童(对照组)的TIM-1基因多态性,计算基因型和等位基因频率,比较各组间关系。结果HSP组基因型及等位基因频率与对照组比较差异无统计学意义(P>0.05),但63例伴肾脏损害者即紫癜性肾炎(HSPN)组与80例不伴肾脏受累组-1454G/A3个基因型间比较差异有统计学意义(P<0.05),且HSPN患儿携带-1454G等位基因频率增高(OR2.375,95%CI1.168～4.830,P<0.05)。结论TIM-1基因启动子-1454G/A基因多态性可能与HSP易感性无关联,但携带-1454G等位基因的患儿出现HSPN风险增高,提示TIM-1基因多态性可能在决定HSP患儿肾脏受累遗传易感性方面有重要作用。     

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??Objective??To explore the diagnostic value of the ratio of α1-microglobulinuria to microalbuminuria in Dent disease. Methods??Data were collected from 8 patients with childhood Dent disease from Jan.1??2014 to Dec.31??2015. The ratio of α1-microglobulinuria to microalbuminuria??and urine protein electrophoresis were monitored and analyzed. Results??In all the 8 cases??α1-microglobulinuria was increased significantly??the ratio of α1-microglobulinuria to microalbuminuria was much higher than 1??and was closely related to the percentage of low molecular weight proteinuria in urine protein electrophoresis ??P??0.05??. Conclusion??The ratio of α1-microglobulinuria to microalbuminuria over 1 can be used as a diagnostic criteria for tubuloproteinuria.     

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目的探讨心力衰竭(CHF)患儿血管紧张素转化酶抑制剂(ACEI)治疗前后血浆基质金属蛋白酶9(MMP-9)、基质金属蛋白酶抑制剂1(TIMP-1)和B型利钠肽(BNP)的变化。方法 2001年1月至2010年6月在四川省宜宾市二医院住院的CHF患儿20例,其中男13例,女7例;年龄3个月至8岁。将患儿分为常规治疗的对照组和加用苯那普利的治疗组。治疗前和治疗6个月后,采用超声心动图测量左心室舒张末期前后径(LVDd)、左心室收缩末前后径(LVDs)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和射血分数(LVEF);采用酶联免疫吸附试验(ELISA)测血清MMP-9、TIMP-1;免疫荧光法测定血清BNP。另选择健康儿童12名为正常组。结果对照组治疗前后LVDd、LVDs及LVEF比较差异无统计学意义(P均>0.05),LVEDV和LVESV治疗后降低明显,差异有统计学意义(P均<0.05);治疗组治疗前后,LVDd、LVDs、LVEDV、LVESV、LVEF差异均有统计学意义(P均<0.05);治疗后治疗组LVDd、LVDs、LVEDV、LVESV降低更明显,LVEF增高更显著,与对照组...     

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目的探讨呼吸道合胞病毒(RSV)支气管肺炎患儿外周血单个核细胞(PBMCS)高迁移率族蛋白B-1(HMGB1)mRNA表达,及血浆肿瘤坏死因子-α(TNF-α)水平、T细胞亚群,并探讨HMGB1、TNF-α、T细胞亚群在RSV支气管肺炎免疫发病机制中的临床意义。方法对2007年9月至2009年3月于苏州大学附属儿童医院呼吸科住院治疗的52例RSV支气管肺炎患儿,其中25例为呼吸道合胞病毒(RSV)感染,27例为RSV和细菌混合感染。同时选择23例健康儿童作对照组,应用逆转录聚合酶链反应(RT-PCR)方法对其PBMCS HMGB1mRNA表达进行检测,并应用ELLSA法检测外周血浆TNF-α,流式细胞仪检测T细胞亚群。结果 (1)3组间PBMCS HMGB1mRNA的表达、血浆TNF-α水平差异有统计学意义(P<0.05),RSV感染组和混合感染组HMGB1的表达差异有统计学意义(P<0.05);(2)CD3+、CD3+CD8+、CD3-CD19+、CD19+CD23+、CD3-CD(16+56)+的百分比在3组间差异均有统计学意义(P<0.05);(3)CD3+、CD3+CD8+、CD3-CD(16+56)+亚群:RSV感染组和混合感染组之间差异无统计学意义(P>0.05),但较对照组有明显降低(P<0.05);(4)CD3-CD19+RSV感染组和混合感染组之间差异无统计学意义,但较对照组明显增高(P<0.05);(5)CD3+CD4+、CD4+CD25+在3组间差异无统计学意义(P>0.05);(6)混合感染组CD19+CD23+、CD4+CD25+较对照组明显增高,差异有统计学意义(P<0.05)。结论 HMGB1可能参与了RSV和细菌混合感染支气管肺炎的免疫发病过程,HMGB1与TNF-α作用机制可能不同。     

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??Abstract??Objective??This study aimed to explore the relationship between the gene expression of FOXP3 and the pathogenesis of Hen?ch-Sch? nlein purpura in children during the acute phase. Methods??The mRNA expression of FOXP3 in the peripheral blood determined in 50 HSP children ??HSP group????34 KD children??KD group and 50 children who would receive tonsillectomy with normal physical examination??control group?? respectively. Results??Altogether 44 cases were included in the final statistical anaylsis??17 in HSP group??14 in KD group and 13 in control group. The mRNA expression of FOXP3 in patients with HSP was remarkably decreased compared to the healthy controls??and there was significant difference between the two groups ??P < 0.05??. The mRNA expression of FOXP3 in patients with KD was also decreased compared to the healthy controls??the difference showing statistical significance ??P < 0.05??.But no statistical difference was found in the mRNA expression of FOXP3 in patients with HSP and KD??P > 0.05??. Conclusion??The decrease of FOXP3 expression might be the indication of immune imsbalance of systematic vasculitis in children??not the specific manifestation of HSP.     

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目的探讨多药耐药基因1(MDR1)C3435T和C1236T多态性与抗癫痫药(AEDs)血药浓度的关系。方法 2009年1月至2010年7月山东大学齐鲁儿童医院和山东大学齐鲁医院儿科门诊长期随访或住院治疗的癫痫患儿184例,服药205例次,其中服用丙戊酸钠(VPA)者110例次、服卡马西平(CBZ)者95例次,采用聚合酶链反应(PCR)和限制性内切片段多态性(RFLP)的方法对服用VPA和CBZ患儿进行MDR1基因C3435T和C1236T分型。采用荧光偏振免疫法测定患者抗癫痫药血药浓度。比较不同基因型间VPA或CBZ血药浓度差异。结果 MDR1基因C3435T多态性中,VPA组基因型CT、CC和TT患者校正后血药浓度分别为(4.17±1.99)、(5.16±2.62)、(4.78±1.72)mg/L,3基因型间差异无统计学意义(P>0.05);CBZ组的CT、CC和TT患者校正后血药浓度分别为(0.72±0.44)、(0.69±0.29)、(0.57±0.43)mg/L,3基因型间差异无统计学意义(P>0.05)。MDR1基因C1236T多态性中,VPA组的CT、CC和TT患者校正后血药浓度分别(3.73±...     

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??Objective??To establish a method to determine steroids in dried blood spots specimens by liquid chromatography-tandem mass spectrometry??LC-MS/MS?? assay. Methods??Two dry blood spots??DBS?? of diameter of 3 mm with different concentration of androstenedione??testosterone??17α-hydroxyprogesterone??progesterone??11-deoxycortisol??21-deoxycortisol and cortisol??were punched. Then the two DBS were extracted with 1??1 methanol/acetonitrile solution??which was labeled with stable isotope internal standards. The extraction of DBS was dried under nitrogen. After reconstituted??the steroids were analyzed by LC-MS/MS. The linearity??precision and accuracy were evaluated. Seven DBS samples of 21-hydroxylase deficiency patients and 23 DBS samples of normal infants were collected??and then the steroids for these samples were analyzed by LC-MS/MS. Results??The intra-day and inter-day precisions were 3.3%??10.9%??and the intra-day and inter-day accuracies were 100.4%??116.5%. The lowest limits of detection??LLOD?? of these seven steroids were 0.03??0.25 μg/L. The lowest limits of quantitation??LLOQ?? of these seven steroids were 0.125??1.00 μg/L. The linearities of different steroids were 0.997??0.999 respectively. The results of non-parametric test about steroids concentration in infants and 21-OHD patients showed that??the concentration of androstenedione??17-hydroxyprogesterone??progesterone??21-deoxycortisol and cortisol in the 21-OHD patients were significantly higher than those steroids in normal infants??P??0.05. Conclusion??A method for measurement of the steroids in DBS by LC-MS/MS has been established??which shows good precision??accuracy and linearity. This method can be applied to clinical testing and follow-up therapy of CAH patients??and it is expected to be used as a second-tier test for CAH newborn screening.     

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??Objective??To observe the efficacy and safety of multi-target immunosuppressive therapy in treatment of children with steroid-resistant nephritic syndrome??SRNS??. Methods??A total of 48 children with SRNS were enrolled in this multicenter prospective study. Based on the same comprehensive treatment??the children were randomly divided into two groups?? ??1??observation group?? they were orally given CSA??3??4 mg/??kg·d???? and MMF??20 mg/??kg·d???? multi-target immunosuppressive therapy????2??control group??they were orally given CSA??4??6 mg/??kg·d????. The side effects were closely observed. The plasma concentrations of CSA??urine protein to creatinine ratios??liver and kidney function??blood routine and urine β2-microglobulin were respectively compared between the two groups after 2 weeks??1 month??3 months and 6 months of treatment. Results??The average plasma concentrations of CSA in the observation group was ??88.86±16.94?? μg/L??and in the control group it was ??152.96±19.20?? μg/L??P??0.001??. The urine protein to creatinine ratios in the observation group after 1 month and 3 months of treatment were lower than the control group in the same time period??P??0.05??. The serum albumin in the observation group after 1 month and 3 months of treatment was higher than the control group in the same time period??P??0.05??. The urine β2-microglobulin in these two groups had no differences during the treatment??P??0.05??. The overall remission rate of the observation group was 88%??and in the control group it was 87%. The remission rate of the observation group after 2 weeks and 1 month of treatment was better than the control group??P??0.05??. The main side effect during therapy was infection??gastrointestinal reaction??crinosity??hypertension and leukocyte decrease. The side effect of the observation group was less than the control group??P??0.05??. Conclusion??The multi-target therapy in children with SRNS by CSA and MMF results in early remission and can keep long-term remission with mild side effect.     

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??Objective To investigate the expression of multidrug resistant-associated protein 1 in the peripheral blood of children with refracotory epilepsy. Methods The expression of MRP1 was detected by RT-PCR and Western blot in children with intractable epilepsy??epilepsy controlled by anti-epileptic drugs ??AEDs?? and healthy children.Results The two methods showed that MRP1 expression in intractable epilepsy was higher than that in epilepsy controlled by anti-epileptic drugs ??AEDs?? and healthy children??P??0.05???? and there was no difference between epilepsy controlled by anti-epileptic drugs ??AEDs?? and healthy children.Conclusion MRP1 overexpresses in peripheral blood of children with refractory epilepsy.     

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??Objective To investigate the features of genetic variants of disks large-associated protein 1??DLGAP1?? gene for autism spectrum disorders??ASD?? in a case control study. Methods Through Affymetrix cytoscan microarrays??297 single nucleotide polymorphisms??SNPs?? covering the DLGAP1 gene were selected and analyzed in ASD patients??n??24?? and non-ASD patients??n??43??. Results Twenty statistically significant SNPs with different inheritance models??Allelic Association test??Genotypic Association test including default model??genotypic model??trend model??dominant model??recessive model and Logistic regression?? were demonstrated in case-control study. Associations of 9 SNPs with ASDs were significant in all models and strong linkage disequilibriums were found between rs9956191 and rs4797127??D’??0.93??LOD??17.08??r2??0.722??and between rs4797180 and rs8091193??D’??1.0??LOD??14.82??r2??0.0.933??.Further haplotype analysis showed that rs9956191/rs4797127??T-G??was statistically and significantly related to ASDs??Permutation??P??0.036??. The haplotype rs9956191/rs4797127??T-G??was significantly associated with the three items of social emotional field and three items of field for interest and stereotyped activities in DSM-V. No significant correlation of sensory perception with this haplotype was found. Conclusion These findings support that the genetic variants of DLGAP1 gene may play a role in ASD.     

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目的观察槐杞黄颗粒辅助治疗原发性肾病综合征(PNS)患儿对淋巴细胞亚群、免疫球蛋白及感染次数的影响。方法 2008-01-01—2009-10-31中国医科大学附属盛京医院小儿肾脏风湿免疫科将住院的101例PNS患儿随机分为A组(62例)和B组(39例),选取正常体检儿童22名为正常对照组。A组采用糖皮质激素联合槐杞黄颗粒治疗,B组单独服用激素。分别于治疗前和治疗3个月、6个月检测患儿的淋巴细胞亚群、免疫球蛋白及记录感染次数、肾病复发次数和药物副反应。结果 (1)A、B组治疗前,CD8+高于正常对照组(P<0.05),CD4+、CD4+/CD8+和NK细胞均明显降低于正常对照组(P<0.05),IgA与IgG均低于正常对照组(P<0.05)。(2)治疗3个月,A组(39例)与B组(30例)之间CD8+细胞差异无统计学意义,两组均明显高于正常对照组,差异有统计学意义(P<0.01);B组CD4+及CD4+/CD8+显著低于A组和正常对照组(P<0.05);A组与B组NK细胞均高于治疗前,B组低于同期A组(P<0.05);IgG明显升高但组间差异无统计学意义。(3)治疗6个月,A组(23例)、B组(9例)间各指标均差异无统计学意义,均低于正常对照组(P<0.01)。(4)感染次数,A组发生上呼吸道感染6例次,肺炎2例次,肾病综合征复发4例次。B组发生上呼吸道感染10例次,肺炎3例次,泌尿系感染2例次,肾病综合征复发6例次。1例患儿服槐杞黄颗粒后出现较严重腹泻(排除感染性腹泻)。结论 PNS患儿治疗前细胞、体液免疫功能降低、紊乱;槐杞黄颗粒辅助治疗过程中,可能通过提高NK细胞和T辅助淋巴细胞活性,减少感染并有减少肾病综合征复发的趋势,且副反应轻微。     

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目的探讨联合降阶梯方案治疗婴幼儿喘息的疗效和安全性。方法以2010年10至12月于上海交通大学医学院附属新华医院哮喘专科门诊及普通儿科呼吸门诊就诊的婴幼儿喘息患儿97例作为研究对象,以规范采用联合降阶梯疗法患儿作为治疗组,以仅采用门诊常规治疗的患儿作为对照组(非联合降阶梯疗法组)。两组均采用相同综合性治疗,包括吸氧、退热等对症处理。治疗组口服泼尼松5mg/d,每天1次,疗程3d;口服阿奇霉素0.1g(/kg·d),疗程3d;每晚用妥洛特罗贴剂1贴(0.5mg/d),疗程7d;口服氯雷他定3mL/d,疗程14d;口服孟鲁司特钠4mg/d,疗程21d。对照组采用目前门诊常用治疗方案,包括采用静脉滴注琥珀氢考或甲强龙、平喘药物、抗生素、祛痰止咳合剂、雾化吸入激素等。结果治疗组患儿咳嗽、喘息、哮鸣音评分及症状体征消失天数显著低于对照组(P<0.05),治疗组1个月内复发次数、治疗费用、家长误工天数显著低于对照组(P<0.05),且治疗组患儿对该方案接受度较高(P<0.05)。结论联合降阶梯疗法应用于婴幼儿喘息疗效肯定,且方便、安全,值得临床应用推广。     

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目的 探讨儿童注意缺陷、多动冲动等行为问题与睡眠障碍(SD)的关系.方法 2006年6月至2007年4月在长沙市5个行政辖区随机抽取1736名6～12岁儿童,对受试儿童的家长进行睡眠状况和注意缺陷多动障碍症状问卷调查.结果 1736名儿童中SD发生率为31.9%.SD组注意缺陷发生率为21.7%、多动冲动13.7%、白天嗜睡35.9%,均较非SD组13.0%、7.9%、24.7%高(P<0.01).行为问题与打鼾的频度有关,经常打鼾组的注意缺陷发生率为31.3%,高于从不打鼾组及偶尔打鼾组(分别为13.9%、16.2%,P<0.01);多动冲动的发生率为18.2%,亦高于从不打鼾组及偶尔打鼾组(分别为8.8%、9.9%,P<0.05).在SD的评分中,注意缺陷发生率高分组达19.2%～26.2%,明显高于其他低分组的10.9%～12.3%(P<0.01);多动冲动最高分组为16.2%,亦比低分组的5.7%～8.3%为高(P<0.01).SD、注意缺陷及多动冲动的发生率均存在性别差异,以男性为高(P<0.01).结论 儿童注意缺陷多动障碍等行为问题与SD相关,对出现注意缺陷多动障碍症状的儿童,有必要关注其睡眠状况.     

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??Objective??To explore the correlation between FeNO levels and airway reversibility and its clinical significance in assessment of children with asthma. Methods??A total of 161 children at 5 to14 years old with asthma admitted to pediatric respiratory outpatient of Shengjing Hospital Affiliated to China Medical University from November 2014 to November 2015 were divided into allergic group and non-allergic group according to the allergic condition. FeNO and bronchial dilatation tests were made in the two groups. The correlation between FeNO levels and improvement rate after bronchodilator in two groups was analyzed. Results????1??FeNO level in allergy group was obviously higher than that in non-allergic group??P??0.002??. ??2?? FeNO level of children in allergic group was positively correlated with improvent of bronchial improvement??P??0.05????and negatively correlated with FEV1%?? FEV1/FVC%?? FEF50%?? FEF25% and FEF75/25% of basic lung function??P??0.05????but was irrelevant to FVC%?? PEF% and FEF75% of basic lung function??P??0.05??.??3??FeNO level of children in non-allergic group was irrelevant to improvement rates of bronchial dilation and basic lung function??P??0.05??. Conclusion??For asthmatic children with allergic constitution??FeNO level is positively correlated with airway reversibility. It may be a good noninvasive predictor for evaluating asthma and airway reversibility in children with asthma. While for children without allergic constitution??FeNO level cannot indicate the airway reversibility effectively.     

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目的 了解2000-2007年广州地区急性呼吸道感染儿童流感嗜血杆茵(Hi)耐药性和2000-2003年分离的Hi血清分型情况,有效指导临床合理用药.方法 采集2000年1月至2007年12月广州市儿童医院门诊及住院的急性呼吸道感染患儿鼻咽分泌物或深部吸痰标本,应用Hi选择培养基进行分离培养;用E-teat法检测Hi对阿莫西林/克拉维酸、头孢呋辛、头胞曲松、氨苄西林、头胞克洛的耐药性,用K-B法检测Hi对阿奇霉素、四环素、氯霉素、复方新诺明的耐药性;采用头孢硝基噻酚显色反应法检测β-内酰胺酶.用玻片凝集法对2000-2003年分离的381株Hi进行血清分型.结果 在8年时间内,Hi对阿莫西林,克拉维酸、头孢呋辛、头胞曲松、阿奇霉素敏感性较高,对氨苄西林、头胞克洛、氯霉素、四环素的耐药率呈逐年上升趋势,复方新诺明的耐药率高迭72.13%;氨苄西林耐药的Hi多重耐药率达82.51%.Hi的产酶率也由2000年的9.91%上升到2007年的36.48%.200-2003年所分离381株Hi的血清分型以不定型株为主,占95.53%,Hib仅占1.57%.结论 广州地区急性呼吸道感染儿童流感嗜血杆菌血清分型以不定型株为主,Hib分离率不高;广州地区急性呼吸道感染儿童Hi的耐药性和产酶率有逐年上升趋势;治疗Hi感染以β-内酰胺类抗茵药物为首选.     

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??Abstract??Objective??To investigate alterations of circulating levels of the inflammatory markers— reflecting brain and adipose tissue inflammation—in the fetal growth restriction??FGR??fetuses and newborns??and explore its possible relation ship with adverse intrauterine development. Methods??Sixty parturients??hospitalized in Shengjing hospital of China Medical University??giving consecutively birth either to 30 appropriate for gestational-age??AGA?? singleton infants ??AGA group ?? or 30 FGR full-term singleton infants ??FGR group????were recruited.Plasm hs-CRP??PAI-1??S100B and leptin levels were determined by enzyme link immune assay??ELISA??in the umbilical cords blood ??UC ?? and venous blood from neonates on postnatal day 1 ??D1?? and day 4??D4??. Results??The birth weight??body length and the body mass index ??BMI?? of the FGR neonates were significantly lower compared with those of AGA group ??P < 0.05??.The leptin levels of UC in the FGR neonates were lower than that in the AGA groups??P < 0.05????and correlated positively with the birth weights and the BMI??P < 0.05??.Plasma hs-CRP levels did not differ significantly at all time points between AGA and FGR groups??P > 0.05??.hs-CRP levels in Umbilical cords blood were significantly decreased when compared with D1 hs-CRP in both AGA and FGR groups ??P < 0.05????and D1 hs-CRP was significantly increasedwhen compared with respective D4 hs-CRP??P < 0.05??.Plasma PAI-1 and S100B levels did not differ significantly at all time points between AGA and FGR groups??P > 0.05????and did not correlated with the birth weights and the BMI. Conclusion??Despite the lower birth weight??BMI and leptin levels in FGRs?? there was no difference for the levels of inflammatory markers hs-CRP and PAI-1 between IUGR and AGA fetuses/neonates.The CRP level in both studied groups fluctuated from fetus to neonate stage might attribute to parturition stress and adaptation recovery.     

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??Abstract??Objective??To investigate the changes of serum and urinary interferon -gamma ??IFN-γ???? interleukin-13 ??IL-13?? and transforming growth factor beta 1 ??TGF-β1?? in the children with primary nephrotic syndrome ??PNS?? and their relationship. Methods??The levels of IFN-γ?? IL-13 and TGF-β1 in the serum and urin of 22 children with PNS were assayed at admission and alleviation respectively by ELISA . The relationship among IFN-γ?? IL-13 and TGF-β1 in serum and urin was detemined by linear correlation analysis .In addition??20 healthy children were included as control group. Results??The levels of serum and urinary IFN-γ and IL-13 at admission were significantly higher than the control group ??q = 24.186?? 29.727?? 33.866?? 26.422 respectively??all P < 0.01???? and markedly dropped?? but were still significantly higher than the control group ??q = 9.074??7.000?? 4.073?? 6.195 respectively??all P < 0.01??at alleviation . The serum and urinary TGF-β1 was markedly increased and dropped at admission and alleviation respectively??q = 19.192??28.160 respectively??all P < 0.01???? and not significanty different ?? q = 0.581?? 0.251 respectively??all P > 0.05?? compared to the control group at alleviation . Serum IFN-γ and serum IL-13 had a significant positive correlation ??r = 0.35??P < 0.01????but not significantly correlated to serum IFN-γ with serum TGF-β1 and serum IL-13 with serum TGF-β1 . Each correlation of IFN-γ?? IL-13 and TGF-β1 in urin respectively and each relation of them in serum and urin were not markedly found . Conclusions??IFN-γ??IL-13??TGF-β1 may be involved in the pathogenesis of PNS . The cytokines may exist a certain degree of relationship?? but the majority is not close .