Comparative study on gene expression in psoriatic lesions versus chronic wound healing processes.

Psoriasis and chronic ulcers not only significantly impair quality of life but also pose a challenge in dermatological treatment. This study aimed to identify new therapeutic targets and biomarkers for psoriasis and chronic ulcers by comparing their gene expression profiles. The gene expression profiles of psoriatic, wound and chronic ulcer patients, as well as healthy controls, were determined via RNA extraction and next-generation sequencing of biopsies. In order to identify biomarkers, functional enrichment, differential expression analysis and machine learning algorithms were implemented. It is worth mentioning that the genes IL17A, TNF, KRT16, MMP9, and CD44 exhibited substantial correlations with the pathogenesis of the conditions being studied. As evidenced by their AUC-ROC values approaching 0.90, machine learning models accurately identified these biomarkers. The differential gene expression was consequently validated via qRT-PCR, which highlighted the increased expression of matrix remodelling enzymes and inflammatory cytokines. Additionally, genes essential for maintaining epidermis integrity and facilitating wound healing exhibited downregulation. These insights into the molecular mechanisms of psoriasis and chronic ulcers pave the way for the development of targeted therapies, offering hope for improved treatment strategies.

The Association Between Admission Anemia and Poststroke Depression.

ABSTRACT: Poststroke depression (PSD) is the most frequent and important neuropsychiatric problem afflicting these patients. Anemia is common in many of these individuals presenting with acute stroke. This study determined whether there is a relationship between anemia on hospital admission and PSD. Two hundred eighty-four acute stroke patients were included in the study. Among them, there were 88 PSD patients, whereas another 196 were non-PSD patients. Clinical depression symptoms were diagnosed according to DSM-4 (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria and a HAMD-17 (the 17-item Hamilton Depression Scale) score ≥8 at 1 month after stroke. In the PSD patients, 27.3% of them presented with anemia, whereas only 12.8% of the non-PSD patients had this condition. There was a negative correlation between hemoglobin level and HAMD-17 score in all patients. A binary logistic regression analysis revealed that anemia was independently associated with PSD after adjustment for sex, National Institutes of Health Stroke Scale scores, mRS (modified Rankin Scale) scores, BI (Barthel Index) scores, RBC (red blood cell), and hematocrit. In conclusion, anemia at admission is associated with PSD seen in these patients 1 month later. Therefore, anemia is a possible predictor of PSD.

[Systematic review and trial sequential analysis of randomized clinical trial of Hongjin Xiaojie Capsules for treatment of hyperplastic disease of breast].

To systemically evaluate the clinical efficacy and safety of Hongjin Xiaojie Capsules for hyperplastic disease of breast(HDBA), so as to provide the evidence for its clinical application. The inclusion criteria are the RCT of single administration of Hongjin Xiaojie Capsules for treatment of HDBA. We retrieved following databases(CNKI, WanFang, VIP, SinoMed, Cochrane Library and PubMed) from their inception to October 1, 2019. Two researchers independently screened out literatures and extracted data, and assessed the methodological quality of eligible RCT according to the criteria in Cochrane Handbook for Systematic Reviews of Interventions. RevMan 5.3 was used for data analysis, binary data was summarized by risk ratio(RR) with confidence intervals(CI) of 95%, and continuous data were summarized by mean difference(MD) with CI of 95%. To estimate the sample size of systematic review, trial sequential analysis(TSA) was performed base on software TSA v0.9 version. Totally 14 RCTs were included, involving 3 057 patients. The results of Meta-analysis showed a significantly higher cure rate(RR=1.13, 95%CI[1.03, 1.25], P=0.01) and higher total effective rate(RR=1.09, 95%CI[1.05, 1.13], P<0.000 1) in Hongjin Xiaojie Capsules group than those in the Juyuansuan Tamoxifen group. The incidence of adverse events was significantly higher in Juyuansuan Tamoxifen group than that in Hongjin Xiaojie Capsules group(RR=0.28 95%CI[0.16, 0.49], P<0.001), and the adverse events included nausea, vomiting, abdominal pain, diarrhea, irregular menstruation, amenorrhea, unclear vision, dizziness and headache. The TSA for the cure rate demonstrated that the current available data reached the expected value. However, due to the low effect intensity of evidence, the pooled results might be affected by high risk bias of trials. The quality of evidence of included trials was generally low or very low. Inverted funnel diagram showed possible publication bias. This review suggested that Hongjin Xiaojie Capsules were potentially effective and safe in treatment of HDBA, especially, the incidences of drug-related adverse events from Hongjin Xiaojie Capsules were significantly lower than those from tamoxifen. However, because of lack of high-quality evidence for drawing a conclusion, more rigorously designed and high-quality trials are needed to confirm the efficacy and safety of Hongjin Xiaojie Capsules.

[Clinical practice guideline for stable chronic obstructive pulmonary disease with traditional Chinese medicine (draft version for comments)].

By referring to the standards and procedures of WHQ Handbook for Guideline Development, under the guidance of relevant laws, regulations, and technical documents, in line with the principle of "evidence-based, consensus-based, experience-based", and based on the best available evidences, fully combined with expert experience and patient preferences, we summarized eight clinical questions in this paper: can traditional Chinese medicine(TCM) treatment improve the clinical symptoms and the degree of dyspnea in patients with stable chronic obstructive pulmonary disease(COPD) Can TCM treatment reduce the number of exacerbations in patients with stable COPD? Can TCM treatment improve the exercise tolerance of patients with stable COPD? Can TCM treatment improve the quality of life of patients with stable COPD? Can TCM treatment delay the decline of lung function in patients with stable COPD? Can TCM treatment improve anxiety and depression in patients with stable COPD? Does the point application therapy benefit patients with stable COPD? Can non-pharmacological treatment benefit patients with stable COPD? Based on these eight clinical problems, the cha-racteristics of TCM itself, and actual clinical situation, the recommendations of TCM to treat the stable COPD were formed in this guideline, with intention to provide advice and guidance to clinicians in the use of TCM to treat stable COPD, to relieve symptoms, improve exercise tolerance, improve health status, prevent disease progression, prevent and treat exacerbations, and improve clinical efficacy. Due to the influence of the user's region, nationality, race and other factors, the implementation of this guideline should be based on the actual situations.

[Study on mechanism of Rhei Radix et Rhizoma-Persicae Semen in treatment of adenomyosis based on network pharmacology].

The aim of this paper was to screen the active targets of Rhei Radix et Rhizoma and Persicae Semen in the treatment of adenomyosis(AM) by means of network pharmacology, and to investigate their mechanism of action. The effective components of Rhei Radix et Rhizoma and Persicae Semen were screened out by using traditional Chinese medicine systematic pharmacological(TCMSP) database, with oral bioavilability(OB) ≥30% and drug-like(DL) ≥0.18 selected as the thresholds. A network was built between the main components and their corresponding targets. Ninety-five human genes corresponding to the medicine targets were obtained from Uniprot database; 220 genes corresponding to AM were obtained from GeneCards database. A total of 21 intersection genes were screened from disease genes and medicine genes, and the protein-protein interaction network interaction(PPI)analysis was conducted by using STRING tool. Disease-target PPI network was drawn by using Cytoscape software, and component-target-disease network was constructed. Twenty-five nodes and 74 connections were found, and then core networks and targets were screened for Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis. The animal model of AM was established by feeding tamoxifen citrate mixed droplets to primary mice for verification of the mechanism. Twenty-three signaling pathways were involved in KEGG pathway enrichment. It was found that the therapeutic mechanism of Rhei Radix et Rhizoma and Persicae Semen on AM may involve multiple targets such as inflammation and immunity, proliferation and apoptosis, endocrine and oxidative stress. Among them, the P53 signaling pathway and the apoptotic signaling pathway which mediated the expression of P53 and BAX may be the important ones. Animal experiments proved that the effective components of Rhei Radix et Rhizoma and Persicae Semen can interfere with the P53 signaling pathway and the apoptotic signaling pathway at the junction of endometrial muscle layer, increase the expression of P53 and BAX in muscle layer cells, and promote the apoptosis of cells with abnormal proliferation ability.

[Clinical practice guideline for Tripterygium Glycosides/Tripterygium wilfordii Tablets in treatment of rheumatoid arthritis].

Tripterygium wilfordii Hook.f.(TwHF) is one of the most effective traditional Chinese herbal medicines against rheumatoid arthritis. As the representative agents of TwHF, Tripterygium Glycoside Tablets(TGT) and Tripterygium wilfordii Tablets(TWT) were included as Class A drugs in the 2019 edition of Medicine Catalogue for National Basic Medical Insurance, Injury Insurance and Maternity Insurance, and TGT was also included in 2018 edition of National Essential Drug List and 2015 edition of Chinese Pharmacopoeia. However, it is difficult to grasp the specific clinical applications of TGT and TWT. Side effects occur from time to time. The curative effect is uneven in patients. And the package inserts of TGT and TWT are not described in details. In order to standardize the clinical application of Tripterygium wilfordii preparations, 38 authoritative units and 48 well-known experts in rheumatoid immunology clinical department, drug supervision and management, pharmacy and evidence-based medicine research fields jointly developed Tripterygium Glycoside Tablets and Tripterygium wilfordii Tablets Medication Guide for reference in clinical application, teaching and scientific research. The guideline followed the "evidence-based, consensus-assisted and experience-based" principles to form "recommendations" for the evidence supported ones, and form "consensus suggestions" for those without evidence support by using nominal group method. In this way, the medication recommendations on function, usage and dosage, drug combinations, precautions, efficacy, safety and other aspects of TGT and TWT can be provided. The application of this Guide will help to avoid or reduce the adverse reactions of T. wilfordii preparations, enhance the efficacy and reduce the cost of medicine, with certain demonstration and promotion values to improve the rational use level of traditional Chinese medicine.

[Editorial explanation for Clinical practice guideline for Tripterygium Glycosides/Tripterygium wilfordii Tablets in treatment of rheumatoid arthritis].

Clinical practice guideline for Tripterygium Glycosides/Tripterygium wilfordii Tablets in the treatment of rheumatoid arthritis(T/CACM 1337-2020) was approved on June, 2020 by the Standardization Office of Chinese Association of Chinese Medicine. Our group developed this guideline for the clinical application of Tripterygium Glycosides/Tripterygium wilfordii Tablets according to the manual for the clinical experts consensus of Chinese patent medicine from January, 2018, when this project was approved by Chinese Association of Chinese Medicine. In this article, the detailed information on our compilation process was provided, in order to facilitate the understanding and the application of the guideline, as well as provide reference for the development of clinical practice guideline for other Chinese patent medicine.

Clinical characteristics of intussusception secondary to pathologic lead points in children: a single-center experience with 65 cases.

OBJECTIVE: Intussusception secondary to pathologic lead points (PLPs) is a challenging condition for pediatric surgeons, and few studies have been published on this subject. The aim of this study was to review and analyze clinical data on the diagnosis and management of intussusception secondary to PLPs in children. METHODS: Between 2002 and 2016, a total of 65 pediatric patients with a diagnosis of intussusception secondary to PLPs were retrospectively reviewed. RESULTS: The series comprised 47 males and 18 females. The average age of the patients was 4.9 years old. All patients had typical clinical manifestations, and intussusception was proven by ultrasound. Fifty-one patients had recurrent intussusception, of whom 21 had one, 14 had two, 10 had three, and 6 had more than three. There were 20 episodes of recurrence within 24 h (39.2%), 15 episodes were found between 24 and 72 h (29.4%), and the remaining 31.4% (16/51) of recurrences occurred after 72 h. All patients received surgical intussusception reduction. Meanwhile, enterectomy was the procedure of choice in 55 patients, polypectomy in 5 patients, and cystectomy in 3 patients. The types of intussusception secondary to PLPs included small intestinal (n = 25), ileocolic (n = 19), ileocecal (n = 11), ileo-ileocolic (n = 9) and cecalcolic (n = 1). The types of PLPs included Meckel diverticulum (n = 32), intestinal duplication (n = 14), benign polyps (n = 5), malignant lymphoma (n = 4), Peutz-Jeghers syndrome (n = 3), mesenteric cyst (n = 3), intestinal wall hematoma of hemophilia (n = 2), allergic purpura (n = 1), and hamartoma (n = 1). All patients recovered well with no relapse during follow-up, except for one patient who had an intestinal obstruction from adhesions that occurred approximately 3 months after discharge and who was curable after conservative treatment. CONCLUSIONS: Intussusception secondary to PLPs tends to exhibit recurrence. There are various types of intussusception secondary to PLPs. It is necessary to improve auxiliary examinations to identify the etiology and avoid intraoperative omission. Surgical reduction of intussusception secondary to PLPs is the preferred clinical management.

Effects of aquaporins on chemosensitivity to cisplatin in ovarian cancer cells.

INTRODUCTION: As water transporters, aquaporins (AQPs) are closely related to other membrane transporters, and water permeability in cell may contribute to chemosensitivity of tumor. To understand the correlation between AQPs and cisplatin (DDP) sensitivity to ovarian cancer cells, effects of DDP on AQPs expression were detected in vitro, and chemosensitivity of DDP was observed in hypertoncity in vitro. METHODS: SKOV3 cells were incubated with DDP, aquaporins blocker mercuric chloride, or in hypertonicity, and cell proliferation inbihition was measured by MTT. Effects of DDP on AQPs mRNA expression cancer cell SKOV3 were measured by RT-PCR. RESULTS: MTT analyses showed that aquaporin blocker and hypertonicity increased the sensitivity of SKOV3 to DDP. The effects of DDP on AQPs expression were different between aquaporin subtypes: following an increase in the incubation time, the expression of AQP1 mRNA decreased significantly, but expression of AQP3 and AQP8 increased. CONCLUSION: Our studies have showed that different subtypes of AQPs play different roles in ovarian cancer cell in vitro, and which suggested that AQPs might be associated with chemotherapy sensitivity of ovarian cancer.

[Pathologic bacterial distribution and antibiotic resistance in induced sputum of infants aged from 1 to 3 months with lower respiratory tract infection].

OBJECTIVE: To investigate the pathologic bacterial distribution and their antibiotic resistance in infants aged from 1 to 3 months with lower respiratory tract infection, so as to provide instructions for clinical application of antibiotics. METHODS: Induced sputum was extracted from 622 cases of hospitalized infants aged from 1 to 3 months with lower respiratory tract infection between January 2013 and December 2013, and microbial sensitivity test was performed with agar diffusion sensitivity test. RESULTS: A total of 379 (60.9%) strains of bacteria were isolated from induced sputum in the 622 infants. The Gram-negative strains were detected in 325 strains (85.8%), and the Gram-positive strains were found in 50 strains (13.2%) in the 379 strains. The others were Fungal strains (4 strains, 1.1%). The Gram-negative bacteria included Escherichia coli (31.1%) and Klebsiella pneumoniae (18.2%), with extended-spectrum ß-lactamases (ESBLs) production of 48.3% and 52.2% respectively. The average rate of antibiotic resistance for ESBLs-producing bacteria was 53%. ESBLs-producing bacteria were highly resistant (100%) to ampicillin and cefotaxime, but sensitive to carbapenems. Staphylococcus aureus (10.0%) was the dominant bacteria in Gram-positive bacteria. A lower proportion of methicillin-resistant Staphylococcus aureus (1.8%) was observed, however the resistance rate of methicillin-resistant Staphylococcus aureus to ß-lactam antibiotics were 100%. CONCLUSIONS: Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria causing lower respiratory tract infection in infants aged from 1 to 3 months. ESBLs-producing bacteria accounted for over 48%, and the antibiotic resistance rate were more than 53% in these infants. These results provide a basis for the first empirical clinical use of antimicrobial in infants with lower respiratory tract infection.

COVID-19 in nursing homes: Geographic diffusion and regional risk factors from January 1 to July 26, 2020 of the pandemic.

BACKGROUND: COVID-19 deaths in nursing homes accounted for 30.2% of all COVID-19 deaths in the United States during the early weeks (1-January to 26-July, 2020) of the pandemic. This study presents the geographic diffusion of COVID-19 cases and deaths in nursing homes during this time period, while also providing explanation of regional risk factors. METHODS AND FINDINGS: Nursing home COVID-19 data on confirmed cases (n = 173,452) and deaths (n = 46,173) were obtained from the Centers for Medicare and Medicaid Services. Weekly COVID-19 case counts were spatially smoothed to identify nursing homes in areas of high COVID-19 infection. Bivariate spatial autocorrelation was used to visualize High vs. Low-case counts and related deaths. Zero-inflated negative binomial models were estimated within Health and Human Service (HHS) Regions at three-week intervals to evaluate facility and area-level risk factors. The first reported nursing home resident to die of COVID-19 was in the state of Washington on 28-February, 2020. By 24-May, 2020 there were simultaneous epicenters in the Northeast (HHS Regions 1 and 2) and Midwest (HHS Region 5) with diffusion into the South (HHS Regions 4 and 6) from 15-June to 5-July, 2020. The case-fatality rate was highest from 25-May to 14-June, 2020 (30.9 deaths per 1000 residents); thereafter declining to 24.1 (15-June to 5-July, 2020) and 19.4 (6-July to 26-July, 2020) (overall case-fatality rate 1-January to 26-July = 26.6). Statistically significant risk factors for COVID-19 deaths were admission of patients with COVID-19 into nursing homes, staff confirmed infections and nursing shortages. COVID-19 deaths were likely to occur in nursing homes in high minority and non-English speaking neighborhoods and neighborhoods with a high proportion of households with disabilities. CONCLUSIONS: Enhanced communication between HHS regional administrators about "lessons learned" could provide receiving state health departments with timely information to inform clinical practice to prevent premature death in nursing homes in future pandemics.

Data independent acquisition reveals in-depth serum proteome changes in uremic pruritus.

Introduction: Uremic pruritus (UP) is a prevalent symptom in patients suffering from uremia, yet its underlying etiology and mechanisms remain incompletely elucidated. Given the significant incidence of UP, identifying specific alterations in proteins present in the blood of UP patients could offer insights into the potential biological pathways associated with UP and facilitate the exploration of biomarkers. Methods: In this study, we employed LC-MS/MS-based data-independent acquisition (DIA) mode to analyze serum samples obtained from 54 UP patients categorized as DKD-UP, HN-UP, and GN-UP (n = 18 for each subgroup), along with 18 uremic patients without pruritus (Negative) and 18 CKD patients without pruritus (CKD). Through DIA mode analysis, a total of 7075 peptides and 959 proteins were quantified. Within these, we identified four upregulated and 13 downregulated Differentially Expressed Proteins (DEPs) in DKD-UP versus Negative, five upregulated and 22 downregulated DEPs in HN-UP versus Negative, and three upregulated and 23 downregulated DEPs in GN-UP versus Negative. Furthermore, we conducted an intersection analysis of the DEPs across these three comparison groups to derive a set of common DEPs (COMP). Subsequently, a total of 67 common DEPs were identified in the three UP groups when compared to the CKD group, with 40 DEPs showing upregulation and 27 DEPs displaying downregulation. Results: Following Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Protein-Protein Interaction (PPI) analyses, we observed that the DEPs distinguishing UP from CKD were primarily associated with mitochondrial function (MT-CYB, PRDX2, TOMM22), inflammation (CD59, CSF1), renal injury (WFDC2), and neural function (CAP1, VGF). Discussion: Our findings contribute to a potential molecular comprehension of UP pathogenesis, shedding light on the identification of these DEPs as plausible biomarkers for UP.

Treatment of cornual heterotopic pregnancy via selective reduction without feticide drug.

STUDY OBJECTIVE: To treat heterotopic pregnancy with a minimally invasive procedure, absent a feticide drug. DESIGN: Retrospective study (Canadian Classification III). SETTING: University-affiliated hospital, center of reproductive medicine, department of obstetrics and gynecology, central south university, Changsha Hunan China. PATIENTS: A total of nine patients' diagnosed cornual heterotopic pregnancy resulted from assisted reproduction technology. Among nine, five patients selected the cornual embryo reduction. INTERVENTIONS: Cornual embryo reduction and preservation of intrauterine embryo were done under guidance of transvaginal ultrasonography at 4-6 weeks after embryo transfer. No drug was given. MEASUREMENTS: Safety of operative procedure and pregnancy outcome. MAIN RESULTS: All five patients who underwent selective embryo reduction has no intraoperative or postoperative complication, however 3 of them delivered healthy babies while two aborted. CONCLUSION: An early intervention should be carried in vital stable patients by means of puncturing and aspirating cornual heterotopic pregnancy under transvaginal ultrasound guidance.

Research progress on the influence mechanism of insulin like growth factors system on growth restriction.

Insulin-like growth factors (IGF) system plays an important role in regulating growth and development of children. The change of this system is closely related to growth restriction caused by various diseases. This article reviews the research progress on how IGF system affects growth.

Semaphorin3A increases M1-like microglia and retinal ganglion cell apoptosis after optic nerve injury.

BACKGROUND: The mechanisms leading to retinal ganglion cell (RGC) death after optic nerve injury have not been fully elucidated. Current evidence indicates that microglial activation and M1- and M2-like dynamics may be an important factor in RGC apoptosis after optic nerve crush (ONC). Semaphorin3A (Sema3A) is a classic axonal guidance protein,which has been found to have a role in neuroinflammation processes. In this study, we investigated the contribution of microglial-derived Sema3A to progressive RGC apoptosis through regulating paradigm of M1- and M2-like microglia after ONC. METHOD: A mouse ONC model and a primary microglial-RGC co-culture system were used in the present study. The expression of M1- and M2-like microglial activation markers were assessed by real-time polymerase chain reaction (RT-qPCR). Histological and Western blot (WB) analyses were used to investigate the polarization patterns of microglia transitions and the levels of Sema3A. RGC apoptosis was investigated by TUNEL staining and caspase-3 detection. RESULTS: Levels of Sema3A in the mouse retina increased after ONC. Treatment of mice with the stimulating factor 1 receptor antagonist PLX3397 resulted in a decrease of retinal microglia. The levels of CD16/32 (M1) were up-regulated at days 3 and 7 post-ONC. However, CD206 (M2) declined on day 7 after ONC. Exposure to anti-Sema3A antibodies (anti-Sema3A) resulted in a decrease in the number of M1-like microglia, an increase in the number of M2-like microglia, and the amelioration of RGC apoptosis. CONCLUSIONS: An increase in microglia-derived Sema3A in the retina after ONC partially leads to a continuous increase of M1-like microglia and plays an important role in RGC apoptosis. Inhibition of Sema3A activity may be a novel approach to the prevention of RGC apoptosis after optic nerve injury.

Interferon Regulatory Factor 3 Deficiency Induces Age-Related Alterations of the Retina in Young and Old Mice.

Age-related changes in visual function and retina structure are very common in aged animals, but the underlying mechanisms of these changes remain unclear. Here we report that the expression of interferon regulatory factor 3 (IRF3), a critical immune regulatory factor, is dramatically down-regulated in mouse retinas during aging. To address the role of IRF3 in the retina, we examined the structure and function of retinas in young (3-4 months) and old (22-24 months) Irf3 -/- mice in comparison to age-matched wildtype (WT) mice. We found that IRF3 deletion resulted in impaired electroretinogram (ERG) responses and decreased retinal thickness in both young and old mice. In addition, numerous synapses of the outer plexiform layer (OPL) were found obviously extending into outer nuclear layer (ONL) in Irf3 -/- mice, along with a reduction of the average synapse density in the OPL. These changes suggest that IRF3 deletion may accelerate retinal senescence. In support of this hypothesis, a number of classic senescence-associated markers were found in remarkably elevated level in Irf3 -/- retina, including p53, p16INK4a, inositol-requiring enzyme 1α (IREα), p-H2A.X and promyelocytic leukemia protein (PML). Overall, our results indicate that maintenance normal IRF3 levels is necessary for retinal structure and function and suggest that IRF3 is an important regulator of retinal senescence.

Prospective clinical and experimental studies on the cardioprotective effect of ulinastatin following severe burns.

OBJECTIVE: To investigate the preventive effect of ulinastatin on shock in the heart after burn. METHODS: In an open prospective clinical study 34 adults with burns >50% total body surface area were randomly divided into control (B) and ulinastatin-treated (U) groups. All underwent routine treatment, and group U received 100,000U ulinastatin intravenously three times a day for 1 week. In an animal experiment, 72 healthy rats underwent equivalent burn, similar division into groups B and U, and resuscitation according to Parkland's formula. Rats in group U received ulinastatin (40,000U/kg) immediately after burn. Myocardial pathomorphology, plasma cTnI, CK-MB and PMNE, myocardial MDA, TNF-alpha, IL-10 and caspase-3 activity and cardiocyte apoptosis were determined. RESULTS: Plasma cTnI, CK-MB, and PMNE were higher in clinical group B than group U. In the animal experiment, plasma cTnI, CK-MB, myocardial MDA, TNF-alpha, IL-10 and caspase-3 activity, and apoptotic index and myocardial pathomorphological changes were significantly less in group U than in group B, save IL-10. CONCLUSION: The clinical and experimental data showed that ulinastatin relieved myocardial damage from severe burn. The mechanism might involve modulation of the anti- and pro-inflammatory balance and lipid peroxidation, and decreased myocardiocyte apoptosis.

Clinical validation of pinopode as a marker of endometrial receptivity: a randomized controlled trial.

OBJECTIVE: To determine the clinical value of pinopodes in the human. DESIGN: Randomized controlled trial. SETTING: Academic fertility center. PATIENT(S): From December 2014 to December 2016, in a phase I trial, 363 patients were recruited in their first IVF cycles. In a phase II trial, 136 patients with at least two previous embryo implantation failures were recruited. INTERVENTION(S): In the phase I trial, in the midluteal phase, endometrial tissues were obtained for scanning electron microscopy, and their IVF treatment outcomes were followed up. In the phase II trial, participants were allocated into two groups by random number table, and the experimental group had twice the number of the control group. Individual ETs (iETs) were performed in the experimental group, while frozen-thawed embryos were routinely transferred in the control group. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR). RESULT(S): In the phase I trial, through receiver operation characteristic curve analysis, the optimal pinopode scoring for successful clinical pregnancy was determined to be 85. The CPR (74.29% vs. 19.77%) and OPR (62.86% vs 11.86%) were significantly higher in the patients whose pinopode scoring was >85. In the phase II trial, the CPR was dramatically higher in the iET group (33.82% vs. 8.11%). CONCLUSION(S): Pinopode scoring is a reliable marker of endometrial receptivity, and iET based on pinopode scoring is a promising solution for recurrent implantation failure. TRIAL REGISTRATION NUMBERS: ChiCTR-OOC-14005617; ChiCTR-OOC-15005882.

Clinical characteristics of Meckel diverticulum in children: A retrospective review of a 15-year single-center experience.

Meckel diverticulum is the most prevalent congenital abnormality of the gastrointestinal tract in children. The aim of this study was to review and analyze clinical data on the diagnosis and management of Meckel diverticulum in pediatric patients. The records of 102 pediatric patients (<14 years old) who underwent surgery for Meckel diverticulum at our institute between 2001 and 2015 were reviewed. Clinical, imaging, laboratory, surgical, and pathological data were recorded. The series comprised 65 males and 37 females with a median age of 5.6 years. Lower gastrointestinal bleeding was the most frequently identified clinical manifestation of Meckel diverticulum, and this manifestation was observed in 41 patients. Intussusception secondary to Meckel diverticulum was identified in 32 patients. Twelve patients presented clinical features of peritonitis; of these patients, 8 had perforated Meckel diverticulum and 4 had Meckel diverticulitis. In 10 patients, Meckel diverticulum was incidentally diagnosed during other surgeries, including appendectomy and neonatal enterostomy. Seven patients were diagnosed with intestinal obstruction. Technetium-99m pertechnetate imaging offered high diagnostic yield. Open surgery was performed on 59 patients, while a laparoscopic approach was employed in 35 patients. The remaining 8 patients did not undergo resection of the Meckel diverticulum. Histology revealed ectopic gastric mucosa in 42 patients (44.7%), ectopic pancreatic tissue in 35 patients (37.2%), mucosa of the small intestine in 15 patients (16.0%), and both gastric and pancreatic ectopic tissue in 2 patients (2.1%). All patients recovered uneventfully except 2 patients in whom an intestinal adhesion obstruction was identified after discharge. Meckel diverticulum had various clinical manifestations in children. Technetium-99m pertechnetate imaging may be useful for diagnosing Meckel diverticulum. Surgical excision of the Meckel diverticulum may be safe and effective in symptomatic patients, and relatively better outcomes can be achieved using this approach.

Molecular epidemiological study of enteroviruses associated with encephalitis in children from Hangzhou, China.

Enterovirus (EV) has over 100 serotypes of species A-D, which can cause various symptoms in infants. Enterovirus encephalitis (EVE) is serve disease with high morbidity and mortality in children. To well define the epidemiology of EVE, we wanted to know more about EV and EV molecular typing by conducting this study in Hangzhou.Cerebrospinal fluid samples were collected from children with diagnosis of encephalitis. Meanwhile, one-step real-time RT-PCR was used for the detection of EV, and we also identified the serotypes of EV by using gene sequencing of VP1 or 5'UTR region.A total of 126 CSF specimens were tested and EV was detected in 26 specimens (20.6%). The molecular typing results showed different types of EV strains including Coxsackievirus B2, Coxsackievirus B3, Echovirus 5, Echovirus 16, Echovirus 18, Echovirus 30, and all EV isolates belonging to the human EV species B.According to the sequence of VP1 and 5'UTR region, E30 may be major cause of children's EVE in Hangzhou, China.