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??Toward New Classification Criteria for Juvenile Idiopathic Arthritis??First Steps??Pediatric Rheumatology International Trials Organization International Consensus was published onJournal of Rheumatologyin October??2018??and then at the2018Annual Meeting of AmericanColleage of Rheumatology??ACR????the relevant experts introduced the samecontent. Although the new JIA classification criteria in the process of improvement in western countries is still??PRINTO has designed a two-step’sprospective study??which will form a mature new JIA classification criteria after itscompletion. The new trend and progress of this subject is of great significance to the diagnosis??treatment and research of JIAin the world. CCIHA has organized a group of relevant Chinese experts to interpret the international consensus??aiming at putting forward suggestions and opinions of Chinese experts on the new classification of JIA??providing a basis for future research on the real world researchof JIA in China??and putting forward the opinions of Chinese experts to be in line with the new international criteria. This paper only interprets faithfully the original English text. The formation and application of JIA’s new classification criteria in China still need further study and discussion.     

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??OBJECTIVE To discuss the effect and mechanism of cinepazide maleate (CM) on myocardial injured rats induced by isoproterenol (Iso). METHODS Fifty male and female rats were divided into normal group, model group, the low and the high dose group of the CM, and captopril (Cap)positive control group. The rat model of myocardial injury was established by subcutaneous injection of Iso (5 mg??kg^-1??d^-1)for 7 d, rats in treatment group were given intraperitoneal injection of CM on the second day (1.5,3 mg??kg^-1??d^-1), rats in positive control group were given intragastric administration of Cap(10 mg??kg^-1??d^-1), and rats in normal group and model group were given intraperitoneal injection of normal saline in the same volume, for 14 d. The rats in each group were tested before and after treatment by three times of running endurance test. After stopping drug all rats were anesthetized for measuring the electrocardiogram (ECG), then taken blood for measuring the activities of serum SOD, LDH and CK, and taken hearts for measuring heart weight index (HWI), left ventricular mass index (LHWI), the contents of myocardial hydroxyproline (Hyp)and MDA, and observing the morphological changes of myocardial tissue by HE staining. RESULTS Compared with rats in normal group, rats in model group showed endurance value decrease, ECG abnormalities (arrhythmia and myocardial ischemia in waveform), increased HWI, LHWI (P<0.01), myocardial Hyp content, myocardial MDA level, and the level of serum LDH and CK, and reduced the serum SOD activity (P<0.05 or P<0.01). Compared with model group, CM could significantly increase endurance value, improve abnormal phenomenon of ECG, lower the HWI, LHWI, myocardial Hyp content, myocardial MDA level, and serum LDH and CK levels were lower, and serum SOD activity increased, especially in high dose group of CM (P<0.01). HE staining showed in the model group rat ventricular remodeling, myocardial rupture, a large number of collagen fibers, in the treatment group, ventricular remodeling and myocardial fibrosis were significantly improved. CONCLUSION Cinepazide maleate has protective effect on myocardial injury of rats induced by Iso.     

Leitlinie zur Betreuung von Neugeborenen diabetischer M��tter

All diabetic women are advised to give birth in a hospital with a pediatric service that allows for continuous intravenous glucose administration, precluding the need for out-of-house transfer of the infant. Women with pre-pregnancy diabetes or on insulin treatment during pregnancy should give birth in a hospital offering round-the-clock neonatal care. Early (breast) feeding is of paramount importance and should be started 30?min after birth, subsequently every 2?C3?h. A mandatory preprandial blood glucose measurement should be taken 2?C3?h after birth and again immediately before the infant is transferred out of the delivery room; subsequent preprandial measurements at 6, 12, and possibly 24?h of age. In the event of three consecutive values of >2.5?mmol/l (45?mg/dl), further controls may be dispensed with. Simultaneously, infants should be checked for symptoms of hypoglycemia by a midwife or nurse on the maternity unit. Clinical findings suspicious for hypoglycemia should prompt immediate blood glucose determinations. Blood glucose concentrations below 2?mmol/l (36?mg/dl; in infants without symptoms) or 2.5?mmol/l (45?mg/dl; in infants with hypoglycemia-related symptoms, prior hypoglycemia, or following asphyxia) require immediate intervention in the form of feeding (preferably breast milk, otherwise hydrolyzed formula, or hydrolyzed starch solution only temporarily), by gavage if necessary. Intravenous glucose administration if blood glucose falls below 1.7?mmol/l (30?mg/dl). Routine echocardiography or laboratory tests (Ca2+, Mg2+, hematocrit, bilirubin) are not necessary unless otherwise indicated. Breast feeding should be consistently encouraged before and after delivery.     

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??Abstracts?? Objective To study the T2* magnetic resonance imaging for evaluation of iron deposition of liver?? pancreas and heart in β- thalassemia major ??β-TM?? patients and the relationship of the serum ferritin with iron overload. Methods Measurement of hepatic?? pancreatic and cardiac MRI T2* was performed in 153 patients with β-TM from May 1?? 2010 to December 31?? 2010??The demographics and serum ferritin ??SF?? were collected. The rate of the iron overload in liver?? pancreas and heart was analyzed. The rates of combined pancreatic and cardiac iron overload in different hepatic iron overload groups were compared. Results According to MRI T2*?? there was serious hepatic iron overload in 85 cases?? moderate in 39?? mild in 21?? no iron overload in 8. Similarly?? there was pancreatic iron overload in 134?? no iron overload in 19. In terms of cardiac iron overload?? there was serious cardiac iron overload in 37 cases?? mild in 21?? no iron overload in 95. No correlation was found between hepatic?? pancreatic and cardiac MRI T2* and age or SF?? but hepatic MRI T2* correlated with pancreatic and cardiac MRI T2*??P = 0.000?? r = 0.529?? r = 0.369???? and pancreatic MRI T2* correlated with cardiac MRI T2* well ??P = 0.000?? r = 0.715??. As grade of hepatic iron overload increases?? the patients demonstrated higher rate of combination of pancreatic and cardiac iron overload simultaneously ??χ2 = 20.78??P = 0.000??.     

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??Objective To investigate the relationship between CCL2-2518A/G gene polymorphism and severity of enterovirus 71??EV71?? infection. Methods CCL2 gene polymorphism in 188 EV71-infected patients and 235 healthy controls were detected by the improved multiplex ligation detection reaction technique??iMLDR??. The level of CCL2 in two groups was determined by enzyme-linked immunosorbent assay??ELISA??. Results No significant differences were found in the distribution of genotype CCL2-2518A/G between EV71-infected patients and the healthy control group??P??0.05??. The G allele??genotypes AG or GG?? in the CCL2-2518A/G??P??0.001?? was more frequent in patients with severe EV71 infection. The level of CCL2 in infected patients was higher than that of the heathy controls ??P??0.05???? the severe cases had higher level of CCL2 than that of the slight cases and healthy controls??P??0.05??. The level of CCL2 in GG gene group was significantly higher than that in AG gene group and the level of CCL2 in AG gene group was significantly higher than that in AA gene group.The people with CCL2-2518G allele??GG+AG?? had higher level of CCL2 than those only with CCL2-2518A allele??AA????P??0.05??. Conclusion The G carrier of the CCL2-2518A/G is found to be associated with severity of EV71 infection??and could be susceptibility factors in the development of EV71 infection.     

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??Objective??To investigate the efficacy and safety of propofol used as anesthesia and deep sedation during flexible bronchoscopy in children. Methods??The clinical data of 206 children with atelectasis who underwent flexible bronchoscopic alveolar lavage in the Endoscopy Room of the Respiratory Department of Hebei Children’s Hospital from January 2016 to January 2017 were retrospectively analyzed. Children for ASA??/?? level were divided into two groups according to the sedation method :there were 106 cases in the propofol group??2 mg/kg?? and 100 cases in the midazolam group??0.1 mg/kg??. To compare the onset time of anesthetict??heart rate??HR????respiratory rate??RR????mean arterial pressure??MAP????percutaneous oxygen saturation??SPO2?? before and after anesthesia induction??T0??T1????during endoscopy placement??T2??and after awakening??T3?? at 4 time points??operative duration??the waked duration of postoperation??the rate of adverse reactions??hiccups??respiratory depression??in the operation and Ramsay score between two groups. All data were analyzed by SPSS 20.0 statistical software. Results????1??There were statistically significant differences at the onset time of anestheticts??operative duration and the rate of side-effects between the two groups??P??0.05??. There was no statistical differences in awake time??P??0.05??.??2??There was no significant difference in MAP or SPO2 at time points of T0??T1??T2??T3??P??0.05????whereas the difference in HR and RR at time points of T1??T2??T3 between the two groups was statistically significant??P??0.05??. ??3??The sedative effect of propofol group was significantly better than that of midazolam group in Ramsay sedative scoring. Conclusion??Propofol used for anesthesia and deep sedation works fast??safely and effectively in flexible bronchoscopy for children??the time to gain consciousness is short??the operation time is short and there is fewer side effects??which is worth promoting.     

Asthma and Rhinitis in South America: How Different They are From Other Parts of the World

Asthma and rhinitis epidemiology has wide variations around the world. The aim of this review was verify the prevalence of asthma and rhinitis in South America and report differences from other regions of the world. We reviewed studies with International Study of Asthma and Allergies in Childhood (ISAAC) methodology in South America, Phases I and III. In South America the ISAAC Phase I ranked four countries among top ten in prevalence of asthma and three countries among top ten in prevalence of rhinoconjunctivitis. ISAAC Phase III showed little changes in asthma and rhinitis prevalence in South American countries. The prevalence increases of asthma and rhinitis in South American centers indicate that the burden of both is continuing to rise, but the differences in prevalence are lessening.