Diazinon (DZN) is a member of organophosphorus insecticides that has cytotoxic effects on different organs. n-Acetyl cysteine (NAC) is a widely used antioxidant in clinical, in vivo and in vitro studies. We evaluated the protective role of NAC against DZN-induced toxicity in kidney tissue of Wistar rats. 30 male Wistar rats were divided into 5 groups of control, single dose of DZN, continuous dose of DZN, single doses of DZN + NAC and continuous doses of DZN + NAC. Kidney function test (blood urea nitrogen, creatinine and uric acid) was provided. Levels of malondialdehyde (MDA), total antioxidant capacity (TAC) and total sulfhydryl (T-SH) were determined in renal tissues. Renal cells apoptosis was detected using TUNEL assay. The mRNA expressions of apoptosis, oxidative stress and inflammatory mediators, including B-cell lymphoma-2 (Bcl2), Bcl-2-associated X protein (Bax), superoxide dismutase (SOD), catalase (CAT), Interleukin 10 (IL-10), Tumor necrosis factor-α (TNF-α), Caspase-3 and Caspase-8 were analyzed in kidney tissues using Real Time PCR method. Chronic exposure to DZN was associated with severe morphological changes in the kidney, as well as impairment of its function and decreased kidney weights. Continues treatment with DZN significantly decreased the percentage of renal apoptotic cells as compared to rats treated with continuous dose of DZN alone (17.69 ± 3.67

Vascular calcification (VC) is an important factor for the increase of both incidence of cardiovascular events and mortality in patients with chronic kidney disease (CKD). Previous studies have shown that macrophages played a key regulatory role in the occurrence, development, and regression of VC. However, the role and mechanism of macrophages in VC of CKD patients are not fully understood. This article reviewed the progress of research on the role and mechanism of macrophages in CKD-related VC with the aim of providing new ideas for the prevention and treatment of VC in CKD patients.

目的 调查分析扬州市在校学生尿液筛查结果特点,为扬州地区儿童尿检异常提供基础数据,对异常尿常规者进行规范管理随访.方法 选取2021年扬州地区部分幼儿园及中小学儿童1973名,年龄6～14岁在校学生,采用尿液分析仪法进行尿常规检测,并对异常结果进行尿液分析仪及尿沉渣复测,分析尿液常规筛查及复检结果.结果 此次尿常规筛查结果:尿隐血初筛阳性率9.22％,复检血尿阳性率0.61％,尿蛋白初筛6.08％,复检0.76％,尿白细胞酯酶阳性初筛5.58％,复测白细胞增多者1.93％,还有少部分其他异常.结论 在校中小学生尿常规异常以儿童尿隐血最为常见,尿蛋白以少量蛋白尿为主,泌尿道感染以女性儿童为多;尿液筛查可以早期发现无症状尿检异常患儿,提供早期干预的时机.

Analyze the expression levels of total IgE, eosinophils, and serum IL-33 in asthmatic and healthy children, and analyze the distribution characteristics of specific IgE in children with asthma.197 children with asthma who attended the clinic between October 2021 and October 2022, as well as 117 healthy children who participated in the clinical examination during the same period were randomly chosen. The distribution of total IgE, eosinophils and serum IL-33 were detected, and ROC curves were drawn to analyze their diagnosis value of childhood asthma. Besides, the characteristics of specific IgE distribution in the 197 children with asthma were also analyzed. The expression level of total IgE, eosinophils and IL-33 were significantly higher in asthmatic children than in healthy children. The analysis of specific IgE indicated that the allergen positive rate of children with asthma was 88.32%, among which 79.42% were multi-allergic. The top three allergens were: mold (48.22%), dermatophagoides pteronyssinus (44.67%), and dermatophagoides farinae and milk (32.99%).Besides, the positive rate for inhalant allergens was 78.17%, and it was 57.36% for food allergens. Results showed that the total IgE, eosinophil percentage, eosinophil and serum IL-33 count were all significantly higher in children with asthma than those in healthy children. Analysis of ROC curves indicated that total IgE, eosinophil count, eosinophil percentage and serum IL-33 were helpful for the diagnosis of asthma. However, no significant differences in total IgE and blood eosinophils were observed between typical asthma and cough allergic asthma. Moreover, the allergy rate and the percentage of multiple allergies were high in children with asthma, and the positive rate of inhalant allergens was higher than that of food allergens. Besides, molds, dermatophagoides pteronyssinuss and dermatophagoides farinae were the most three common allergens in children with asthma, and the positive rate of typical asthma allergens was higher than that of cough variant asthma.This manuscript reflects our findings that Diagnostic value of the total IgE, eosinophils and serum IL-33 in childhood asthma.Besides，we analyze the distribution of allergens in children in Yangzhou, China.We thereby believe that the data contained in our manuscript are of importance and will be of interest to the wide readership of World children asthma.

目的:探讨对症治疗、槐杞黄联合小剂量肝素预防过敏性紫癜性肾炎的临床效果.方法:选取2020年1月—2022年12月扬州大学附属医院儿科收治的过敏性紫癜患儿32例作为观察对象,随机分为观察组与对照组,各16例.对照组给予小剂量肝素治疗,观察组在对照组基础上给予槐杞黄治疗.比较两组临床治疗效果、免疫功能改善情况、肾功能指标改善情况及过敏性紫癜性肾炎发生情况.结果:观察组临床治疗总有效率高于对照组,差异有统计学意义(P=0.0325);治疗后,观察组免疫球蛋白A、免疫球蛋白G水平均低于对照组,差异有统计学意义(

Objective To explore the experience and feelings of school-age obese children with asthma and their parents on fear of physical activity based on fear-avoidance model,in order to provide a basis for the construction of targeted exercise intervention programs for children with asthma. Methods From October 2021 to January2022,the purposive sampling was used to select 13 cases of school-age obese asthmatic children and their parents for semi-structured in-depth interviews in the pediatric asthma outpatient department of a tertiary A hospital in Yangzhou City. Data was analyzed by Colaizzi phenomenon analyzing methods. Results Combined with the fearavoidance model,3 themes are summarized,including the unscientific cognition of physical activity（physical activity can induce a variety of uncomfortable symptoms;parents can’t tell if discomfort after physical activity is an acute attack of asthma;some parents are over-alert to obesity and force children to physical activity）;the way to deal with the fear of physical activity（children actively avoid physical activity;parents limit children’s physical activity）;the adverse consequences of fear of physical activity（the increasing sedentary behavior affects the exercise endurance of children,further aggravating their obesity and fear of physical activity;communication between children and peers was reduced,triggering a sense of inferiority,further aggravating the fear of physical activity）. Conclusion The experience and feelings of fear of physical activity in school-age children with obesity and asthma and their parents were more complex with some unscientific cognitions. In clinical practice,measures should be taken to improve the cognitive level of children and their parents on appropriate and moderate physical activity,avoid excessive vigilance on exercise,reduce fear of physical activity,and promote scientific physical activity in children.

目的 构建江苏扬州地区11～12岁健康儿童肺功能参数的预计方程式.方法 前瞻性选择扬州地区5所小学的595名11～12岁健康儿童作为研究对象,其中男334名、女261名,采用肺功能仪测定其肺通气功能.以呼气流量峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、一秒率(FEV1/FVC)4项参数实测值为因变量,以年龄、身高、体质量、体质量指数为自变量,通过多元逐步回归分析建立不同性别儿童的肺功能预计方程式,并采用相对预测误差平均值评价预计方程式的适用性.结果 12岁男童的身高、体质量、体质量指数和PEF、FEV1、FVC水平均高于11岁男童,12岁女童的身高、体质量、体质量指数、收缩压、舒张压和FEV1、FVC水平均高于11岁女童,差异有统计学意义(P＜0.05);11岁男童的血压、体质量指数均高于11岁女童,12岁男童的身高低于12岁女童,体质量指数高于12岁女童,差异有统计学意义(P＜0.05).相关性分析结果显示,男童的年龄、身高、体质量、体质量指数均与PEF、FEV1、FVC分别呈正相关(P＜0.01),身高与FEV1/FVC呈负相关(P＜0.01);女童的身高、体质量、体质量指数均与FEV1、PEF分别呈正相关(P＜0.01或P＜0.05),年龄与FEV1呈正相关(P＜0.01).男童肺功能预计方程式分别为PEF(L/s)=0.032H+0.261A-4.306,FEV1(L)=0.028H+0.092A-3.098,FVC(L)=0.042H+0.101A-4.858,女童肺功能预计方程式分别为 PEF(L/s)=0.040H-2.855,FEV1(L)=0.033H-2.935,其中H指身高(cm),A指年龄(岁).与其他研究的预计方程式相比,本研究构建的回归方程对本研究群体有较好的适用性.结论 本研究构建的扬州地区11～12岁健康儿童肺通气功能主要参数预计方程式,可为该地区儿童肺通气功能相关参数的预测提供帮助,进而为临床准确判定儿童肺功能异常奠定基础.

Secondary brain damage caused by hyperactivation of autophagy and inflammatory responses in neurons plays an important role in hypoxic-ischemic brain damage (HIBD). Although previous studies have implicated Toll-like receptor 4 (TLR4) and nuclear factor kappa-B (NF-κB) in the neuroinflammatory response elicited by brain injury, the role and mechanisms of the TLR4-mediated autophagy signaling pathway in neonatal HIBD are still unclear. We hypothesized that this pathway can regulate brain damage by modulating neuron autophagy and neuroinflammation in neonatal rats with HIBD. Hence, we established a neonatal HIBD rat model using the Rice-Vannucci method, and injected 0.75, 1.5, or 3 mg/kg of the TLR4 inhibitor resatorvid (TAK-242) 30 minutes after hypoxic ischemia. Our results indicate that administering TAK-242 to neonatal rats after HIBD could significantly reduce the infarct volume and the extent of cerebral edema, alleviate neuronal damage and neurobehavioral impairment, and decrease the expression levels of TLR4, phospho-NF-κB p65, Beclin-1, microtubule-associated protein l light chain 3, tumor necrosis factor-α, and interleukin-1β in the hippocampus. Thus, TAK-242 appears to exert a neuroprotective effect after HIBD by inhibiting activation of autophagy and the release of inflammatory cytokines via inhibition of the TLR4/NF-κB signaling pathway. This study was approved by the Laboratory Animal Ethics Committee of Affiliated Hospital of Yangzhou University, China (approval No. 20180114-15) on January 14, 2018.

目的 探讨0 ～ 14儿童31 d反复再入院的独立危险因素及分析进行干预的效果,为临床工作提供参考与指导.方法 本研究先期通过对2013-2014年出院后31d再入院病例进行回顾性分析发现9组因素差异有统计学意义(P＜0.05),其为肺炎支原体感染、两联抗生素使用、基础疾病、哮喘、湿疹、被动吸烟、院内感染、家长感染、父母文化;进一步进行多因素Logistic回归分析结果显示其中6组因素为31 d再入院的独立危险因素,包括肺炎支原体感染、基础疾病、被动吸烟、院内感染、家长感染、父母文化,将之作为对照组.后对2015-2016年10 341例患儿相关独立危险因素进行干预作为试验组,比较两者之间再入院率及相关可干预独立危险因素发生率有无差异.结果 2013-2014年共收集9 456例,31 d再入院450例,占总病例数4.8％;2015-2016年共收集10 341例,31d再入院430例,占总病例数4.1％,两者差异有统计学意义(P＜0.05).可干预独立危险因素中支原体感染、院感、家长感染在干预后(试验组)在再人院患儿中发生率显著低于干预前(对照组),差异有统计学意义(P＜0.05).结论 针对住院患儿医院应注意积极健康宣教,在肺炎支原体感染的规范、足疗程治疗中加强重视,尽量减少患儿被动吸烟比例,积极降低院内感染发生率,对存在呼吸道感染的患儿家长及时采取有效的隔离措施,从而达到降低患儿再入院比率的目的.

目的\r\n探讨难治性肺炎支原体肺炎的儿童，其肺通气功能与胸部CT改变类型的相关性。\r\n\r\n\r\n方法\r\n收集2014年1月至2017年12月在我院儿科住院的患有难治性肺炎支原体肺炎的患儿90例。对于大于5周岁以上的60例患儿评估其常规肺通气功能指标的差异，对于5周岁以下的30例患儿评估潮气呼吸指标的差异。根据胸部CT的检查结果，将患儿分为磨玻璃样改变组(磨玻璃样改变组)、肺实变患儿(实变组)、斑片影改变的患儿(斑片组)。\r\n\r\n\r\n结果\r\n对于大于5周岁的60例患儿中，CT的检查结果提示磨玻璃样改变组有14例，实变组有26例，斑片组有20例。磨玻璃样改变组、实变组以及斑片组患儿常规肺功能的FVC占预计值分别为(65.23±12.41)%、(75.86±19.08)%和(88.29±19.41)%，FEV1占预计值分别为(63.05±13.21)%、(69.02±19.46)%和(88.54±19.52)%，FEV1/FVC分别为(93.49±11.28)%、(86.55±14.13)%和(97.20±13.01)%，PEF占预计值分别为(52.31±16.25)%、(57.12±15.03)%和(64.30±18.64)%，MMEF25～75分别为(52.41±21.29)%、(43.90±23.10)%和(70.58±26.87)%，上述组间数据之间的差异具有统计学的意义(P\u003c0.05)。对于5周岁以下的30例患儿中，CT的检查结果提示磨玻璃样改变组有8例，实变组有9例，斑片组有13例。磨玻璃样改变组、实变组以及斑片组患儿的潮气呼吸肺功能的TPTEF/TE分别为%(23.16±7.69)、(25.12±8.42)%和(27.56±8.63)%，VPEF/VE分别为(27.59±5.13)%、(29.63±5.68)%和(31.42±6.21)%，Ti/Te分别为(0.76±0.13)、(0.71±0.15)和(0.79±0.21)，VT分别为(12.10±2.34)ml/kg、(12.25±2.63)ml/kg和(13.52±2.61)ml/kg。上述组间数据之间的差异具有统计学的意义(P\u003c0.05)。\r\n\r\n\r\n结论\r\n难治性肺炎支原体肺炎患儿不同的胸部CT改变与肺功能之间的改变有着多样性以及特异性，胸部CT显示磨玻璃样改变的患儿多存在限制性及阻塞性通气功能的障碍，肺实变的患儿多数存在大小气道阻塞的障碍，斑片样改变的患儿仅存在轻度大气道阻塞性病变。

Objective To explore the inhibitory effect of immune complex (IC) on the signal pathways of high-expressed CD40 and CD80 induced by Toll-like receptor (TLR9) agonist CpG oligodeoxynucleotide (ODN) in B lymphocytes. Methods The mice were intraperitoneally injected with CpG ODN or IC plus CpG ODN, and the spleen CD19+ B lymphocytes were sorted by magnetic-activated cell sorting (MACS). The expressions of CD40 and CD80 on the B lymphocytes were detected by flow cytometry. The spleen B lymphocytes were isolated from wild type and immunoglobulin G Fc receptor Ⅱb (FcγRⅡb) knockout mice by MACS. After the isolated cells were stimulated with CpG ODN or IC plus CpG ODN in vitro, the phosphorylation levels of related protein kinases were detected in the B lymphocytes by Western blotting. Following CpG ODN stimulation, the B lymphocytes were treated with JNK p38 inhibitor SP600125 (50 μmol/L) or p38 inhibitor SB203580 (20 mg/L), and then the CD40 and CD80 expression levels on the CpG ODN-activated B lymphocytes were detected by flow cytometry. Results IC inhibited CD40 and CD80 expressions on the CpG ODN-activated B lymphocytes in vivo (both P<0.05). IC inhibited the phosphorylation levels of JNK and p38 induced by CpG ODN in B lymphocytes, but did not inhibit them in the B lymphocytes from FcγRⅡb-/- mice. The CD40 and CD80 expressions on the CpG ODN-activated B lymphocytes were significantly decreased after treated with SP600125 and SB203580 (both P<0.01). Conclusion IC can inhibit the CD40 and CD80 expressions induced by TLR9 agonist CpG ODN through inhibiting the JNK and p38 pathways in B lymphocytes.

目的 分析与探讨肺泡灌洗术对于治疗肺炎支原体患病小儿病症的临床效果.方法 资料选取的时间段为2014年1月~2016年12月,以在此期间于我院接受肺炎支原体肺炎治疗的小儿患者48例作为本次观察与研究的对象,按照随机划分的原则等分成对照组与实验观察组;其中对对照组患病小儿所采用的疗法是传统型治疗方式,对实验观察组则采用传统型治疗方式与肺泡灌洗术相结合的方式,对两组的临床效果进行统计学意义上的分析与探究.结果 在采取治疗的两天内,实验观察组患病小儿的二氧化碳分压指标占据了明显优势;因P<0.01,因此此结果具有统计学意义;且实验观察组的有效治疗率也呈现出显著优势,P<0.01,比较具有统计学意义.结论 肺泡灌洗术具有较强的临床推广意义和医学实践价值.

回顾性分析2015年1月至2016年12月期间我院住院的82例传染性单核细胞增多症患儿的临床资料,根据年龄(＜3岁、3～6岁、＞6岁)分组,分析各年龄组临床表现.结果发现,发热、颈部淋巴结肿大及皮疹的发生率各年龄组间无统计学差异(均P＞0.05);肝脾肿大及肝功能异常3组存在统计学差异(均P＜ 0.05);退热、扁桃体消退及淋巴结消退时间各年龄组无统计学差异(均P＞ 0.05).

目的：分析纤维支气管镜肺泡灌洗术治疗儿童社区获得性肺炎重症或难治性肺炎的疗效，探讨如何早期识别并及早进行纤支镜治疗的重要性。方法：2014年1月～2015年7月间，我科运用纤支镜肺泡灌洗术治疗难治性肺炎患儿46例，分析病例特点及镜下表现。结果：进行纤支镜肺泡灌洗的病例镜下均有气管支气管的黏膜炎症损伤；36例有较多分泌物，其性状与所感染病原体有关；痰栓形成者15例，气道炎性狭窄者9例，气道通气不良者24例。灌洗液细胞形态学检查异常。肺部病变26例患儿术后1周内明显吸收，17例患儿在7～14 d吸收，3例患儿在2周以上才吸收。结论：对于儿童难治性肺炎，纤支镜肺泡灌洗术能明显促进肺炎吸收，疗效好。如果早期即有明显的反复高热，常规治疗1周左右难以退热，X线检查无明显好转吸收者，提示常规治疗效果不好，应该尽早进行气管镜检查。

目的 分析普米克令舒联合可必特压缩雾化在小儿喘息性肺炎中的疗效.方法 选取我科收治的160例喘息性肺炎患儿,将其随机分成观察组(83例)和对照组(77例).所有患儿均给予止咳、化痰、退热及抗感染等基础治疗,观察组患者在基础治疗上给予普米克令舒联合可必特压缩雾化治疗,对照组患者在基础治疗上给予口服硫酸特布他林片,口服或者静脉激素等平喘治疗.比较2组患儿咳嗽消失、喘息缓解、肺部啰音消失、肺部影像学恢复及住院日和治疗7d后临床总有效率.结果 观察组患儿应用普米克令舒雾化吸入治疗后,咳嗽消失、喘息缓解、湿哆音消失、肺部影像学恢复及住院日与对照组患儿无明显差异(P＞0.05).结论 普米克令舒联合可必特压缩雾化,对小儿轻中度喘息性肺炎有较好的疗效,且能减少全身用激素及β受体激动剂的不良反应,值得临床推广应用.

目的：评估电子支气管镜肺泡灌洗术对儿童重症肺炎支原体肺炎的治疗作用。方法对符合重症肺炎支原体肺炎诊断标准，同时符合大叶性肺炎诊断标准102例患儿，依据是否行支气管镜肺泡灌洗分为支气管镜组48例，未灌洗54例（对照组）。结果支气管镜组患儿经治疗后热退时间、咳嗽改善时间、肺部体征消失时间、住院时间均低于对照组（P<0.01）；支气管镜组6周后门诊随访肺部炎症吸收率为97.92%（47/48），对照组6周后门诊随访肺部炎症吸收率为77.78%（42/54），支气管镜组明显高于对照组（P<0.05）；影像学的改善在2，4周时支气管镜组都明显优于对照组，差异有统计学意义（P<0.05）。结论早期支气管镜肺泡灌洗术可清除重症肺炎支原体肺炎气道痰栓，减轻炎症。

目的探讨微生态制剂思连康联合蒙脱石散治疗小儿急性腹泻病的临床疗效。方法将120例腹泻病患儿随机分成治疗组和对照组,治疗组60例,对照组60例,均给予口服蒙脱石散及对症治疗,治疗组加用微生态制剂,比较2组疗效。结果治疗组总有效率为95%,对照组总有效率为80%,二者比较差异有统计学意义。结论微生态制剂与蒙脱石散联合治疗小儿急性腹泻病疗效好,值得临床推广使用。