The safety and effectiveness of clopidogrel versus aspirin in Kawasaki disease with mild-to-moderate liver injury.

Kawasaki disease can be combined with liver injury. As a mainstay treatment for Kawasaki disease, aspirin may cause liver injury. This study aimed to compare the safety and effectiveness of clopidogrel versus aspirin in Kawasaki disease with mild-to-moderate liver injury. This study retrospectively analysed 166 children with Kawasaki disease combined with mild-to-moderate liver injury. The children treated with clopidogrel were less likely to have aggravated liver injury than those treated with aspirin (n = 2/100 vs. n = 13/66, P < 0.001). The initial alanine aminotransferase value of the clopidogrel group was higher (131.5 [98.5, 167.5] vs. 96 [72, 133], P < 0.001), while the time of alanine aminotransferase recovery to normal was similar (5 [4, 7] vs. 4 [3, 7], P = 0.179). No significant fever differences observed between groups: 7.5 [6, 9] for aspirin vs. 7 [6, 8] for clopidogrel group, P = 0.064. The probability of nonresponse to intravenous immunoglobulin (n = 29/100 vs. n = 30/66, P = 0.030) and the days of hospitalization (n = 6 [4, 9] vs. n = 7 [5, 10], P = 0.007) in the clopidogrel group were less than those in the aspirin group. In conclusion, the application of clopidogrel is potentially superior to aspirin in Kawasaki disease combined with mild-to-moderate liver injury.

The microbial communities in Zaopeis, free amino acids in raw liquor, and their correlations for Wuliangye-flavor raw liquor production.

Wuliangye-flavor liquor (WLFL), a specific Chinese traditional liquor, one of the major type of global distilled spirits, offers a unique flavor system acquired across thousands of years of development. Free amino acids (FAAs), as major health factors, are considered to be primarily derive from the hydrolysis of protein from the Zaopeis (ZPs) by microbial populations during fermentation. Here, we investigated the changes of microbial communities in ZPs and FAAs in raw liquor (RL) directly related ZPs from different ages of WLFL fermentation pits by phospholipid fatty acid fingerprint (PLFA) and high performance liquid chromatography method. Results indicated that the total PLFAs of 20- and 50-year ZPs were significantly higher (p < .05) than 1- and 5-year ZPs. Gram-positive bacteria (G+), anaerobic bacteria, and fungi were dominant in the ZPs. Furthermore, the total of FAAs content was highly increased (p < .05) in RLs of aged fermentation pit (20- and 50-year, 24.86-30.23 mg/g, 28.73-37.15 mg/g) compared with young (1- and 5-year, 20.97-26.46 mg/g, 17.83-28.70 mg/g), while, the different ages of RLs could be distinguished according to 9 biomarkers of FAAs (Variable importance in projection, VIP >1; p < .05), including tyrosine, aspartic acid, leucine, glutamic acid, citrulline, alanine, proline, glycine, and valine. Particularly, the biomarkers of FAAs were positively correlated with gram-negative bacteria (G-) and fungi, but negatively correlated with G+. This is the first report to uncover the microbial communities in zaopeis, free amino acids in RL, and their correlations for Wuliangye-flavor raw liquor production.

Receptor for advanced glycation end products involved in circulating endothelial cells release from human coronary endothelial cells induced by C-reactive protein.

OBJECTIVES: This study was designed to investigate the effect of receptor for advanced glycation end products (RAGE), S100A12 and C-reactive protein (CRP) on the release of circulating endothelial cells (CECs) from human coronary artery endothelial cells (HCAECs). MATERIALS AND METHODS: HCAECs were cultured in increasing concentration of CRP (0, 12.5, 25, 50µg/ml) or S100A12 protein (0, 4, 10, 25µg/ml) for 24 hr. CECs were measured by flow cytometry. Small interfering RNA (siRNA) was designed to decrease RAGE level. Fluorescence microscopy and real-time quantitative polymerase chain reaction were used to assess the efficiency of siRNA silencing RAGE. The release of CECs from HCAECs was further evaluated by flow cytometry. RESULTS: CRP caused a significant increase in the release of CECs from HCAECs. The number of CECs increased by about 2-fold in 25 µg/ml CRP-treated group compared to the control group (12.22% compared to 6.82%, P=0.032). But S100A12 failed to increase the release of CECs from HCAECs. Blockade of RAGE by siRNA significantly decreased the release of CECs induced by CRP (13.22% of CRP group compared to 8.77% of CRP+siRNA group, P=0.017). CONCLUSION: RAGE is involved in the release of CECs induced by CRP, and the effect can be attenuated by silencing RAGE. RAGE may play an important role in endothelial dysfunction in cardiovascular disease. Inhibition of RAGE may be a therapeutic target for coronary artery lesions in Kawasaki disease.

Cardioprotection of H2S by downregulating iNOS and upregulating HO-1 expression in mice with CVB3-induced myocarditis.

AIMS: To explore the effects and potential mechanisms of hydrogen sulfide (H2S) in CVB3-induced mice with myocarditis. MAIN METHODS: A total of 75 six-week-old inbred male Balb/c mice were divided randomly into four groups (N, C, P and S). Group N was the negative control. The others were inoculated intraperitoneally (i.p.) with CVB3. Subsequently, groups P and S were injected i.p. once a day with DL-Proparglygylcine (PAG) and NaHS respectively. Group C was the positive control. Inducible nitric oxide synthase (iNOS) and heme oxygenase-1(HO-1) expression on cardiac tissues were evaluated by histopathological examination, immunohistochemistry, RT-PCR and Western blot. KEY FINDINGS: The heart-weight to body-weight (HW/BW) ratio, the histologic scores and the iNOS mRNA and protein expression levels were higher, and the HO-1 mRNA and protein expression levels were lower in mice treated with PAG than those mice solely inoculated with CVB3. Mice in group S had a significant decreased in the HW/BW ratio, the histologic scores and the iNOS mRNA and protein expression levels, and had a significant increased in the HO-1 mRNA and protein expression levels compared to the mice in group C. H2S can attenuate inflammatory cell infiltration, alleviate cardiac edema, and limit myocardial lesions. SIGNIFICANCE: Our data support that H2S can inhibit iNOS overexpression and induce HO-1 expression, both of which contribute to the cardioprotection of H2S in CVB3-induced mice myocarditis.

[Six Kawasaki disease patients with acute coronary artery thrombosis].

OBJECTIVE: To improve the awareness of acute coronary artery thrombosis in Kawasaki disease (KD). METHOD: Six KD patients with acute coronary artery thrombosis (Jan. 2004 to Jan. 2013) were studied retrospectively. The basic information, clinical manifestations, laboratory data, echocardiography and electrocardiography (ECG), method and consequence of thrombolytic therapy were analyzed. RESULT: The mean age of patients with coronary artery thrombosis (5 males and 1 female) was (17.2 ± 11.3) months.Five cases had thrombosis in left coronary artery (LCA), and four cases had thrombosis in aneurysm of left anterior descending artery (LAD). One case had thrombosis in both left and right coronary artery (RCA).One case died. Maximum thrombus was about 1.60 cm × 0.80 cm, locating in LAD. The diameter of LCA and RCA was (0.44 ± 0.07) cm and (0.45 ± 0.07) cm. Two patients showed abnormal ECG. Case 3 showed ST segment depression in lead V5. Case 6 showed myocardial infarction.In acute phase of KD, three patients received treatment with intravenous immunoglobin (IVIG), five patients were treated with aspirin.In sub-acute and convalescent phase of KD, all patients were treated with low-dose aspirin.Warfarin and dipyridamole were applied in 5 patients. All cases were treated with thrombolytic therapy using urokinase and/or heparin. After thrombolytic therapy, echocardiography showed thrombolysis in four cases and no change in one.One patient died of myocardial infarction. CONCLUSION: Most of acute coronary thrombosis in KD occurred in LAD. KD patients with coronary artery thrombosis are at risk of sudden death due to myocardial infarction.