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1.
Eur J Pediatr ; 183(3): 1233-1244, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38091068

RESUMO

This study aims to examine the clinical characteristics and outcomes of clinical myocarditis in pediatric patients in China. This is a multicenter retrospective study. Children diagnosed with clinical myocarditis from 20 hospitals in China and admitted between January 1, 2015, and December 30, 2021, were enrolled. The clinical myocarditis was diagnosed based on the "Diagnostic Recommendation for Myocarditis in Children (Version 2018)". The clinical data were collected from their medical records. A total of 1210 patients were finally enrolled in this study. Among them, 45.6% had a history of respiratory tract infection. An abnormal electrocardiogram was observed in 74.2% of patients. Echocardiography revealed that 32.3% of patients had a left ventricular ejection fraction of less than 50%. Cardiac MRI was performed in 4.9% of children with clinical myocarditis, of which 61% showed localized or diffuse hypersignal on T2-weighted images. Serum levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and N-terminal B-type natriuretic peptide (NT-proBNP) were higher in patients with fulminant myocarditis than in patients with myocarditis, making them potential risk factors for fulminant myocarditis. Following active treatment, 12.1% of patients were cured, and 79.1% were discharged with improvement. CONCLUSION: Clinical myocarditis in children often presents with symptoms outside the cardiovascular system. CK-MB, cTnI, and NT-proBNP are important indicators for assessing clinical myocarditis. The electrocardiogram and echocardiogram findings in children with clinical myocarditis exhibit significant variability but lack specificity. Cardiac MRI can be a useful tool for screening clinical myocarditis. Most children with clinical myocarditis have a favorable prognosis. WHAT IS KNOWN: • Pediatric myocarditis presents complex clinical manifestations and exhibits varying degrees of severity. Children with mild myocarditis generally have a favorable prognosis, while a small number of children with critically ill myocarditis experience sudden onset, hemodynamic disorders, and fatal arrhythmias. Therefore, early diagnosis and timely treatment of myocarditis are imperative. WHAT IS NEW: • To the best of our knowledge, this multicenter retrospective study is the largest ever reported in China, aiming to reveal the clinical characteristics and outcomes of pediatric clinical myocarditis in China. We provided an extensive analysis of the clinical characteristics, diagnosis, treatment, prognosis, and factors impacting disease severity in pediatric clinical myocarditis in China, which provides insights into the epidemiological characteristics of pediatric clinical myocarditis.


Assuntos
Miocardite , Criança , Humanos , Miocardite/diagnóstico , Miocardite/terapia , Estudos Retrospectivos , Volume Sistólico , Função Ventricular Esquerda , Creatina Quinase Forma MB , Arritmias Cardíacas , China/epidemiologia
2.
Zhongguo Dang Dai Er Ke Za Zhi ; 25(11): 1170-1174, 2023 Nov 15.
Artigo em Zh | MEDLINE | ID: mdl-37990463

RESUMO

OBJECTIVES: To study the clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy (ANE) in children. METHODS: A retrospective analysis was conducted on the medical data of 12 children with SARS-CoV-2 Omicron variant infection-associated ANE who were admitted to the Pediatric Intensive Care Unit, Qingdao Women and Children's Hospital from December 18 to 29, 2022. The children were divided into two groups based on outcomes: death group (7 cases) and survival group (5 cases). The clinical manifestations and auxiliary examination results were compared between the two groups. RESULTS: The median age of the 12 patients was 30 months, with a male-to-female ratio of 1:1. All patients presented with persistent high fever, with a median highest body temperature of 41℃. The median time from fever onset to seizure or consciousness disturbance was 18 hours. The death group had a higher proportion of neurogenic shock, coagulation dysfunction, as well as elevated lactate, D-dimer, interleukin-6, interleukin--8, and interleukin-10 levels compared to the survival group (P<0.05). CONCLUSIONS: Children with SARS-CoV-2 Omicron variant infection-associated with ANE commonly present with persistent high fever, rapidly progressing disease, and have a high likelihood of developing consciousness disorders and multiorgan dysfunction within a short period. The occurrence of neurogenic shock, coagulation dysfunction, and significantly elevated cytokine levels suggests an increased risk of mortality.


Assuntos
Transtornos da Coagulação Sanguínea , Encefalopatias , COVID-19 , Humanos , Feminino , Criança , Masculino , Lactente , SARS-CoV-2 , Estudos Retrospectivos , COVID-19/complicações , Encefalopatias/etiologia , Prognóstico , Febre
3.
Mol Cell Biochem ; 464(1-2): 83-91, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31741130

RESUMO

Kawasaki disease is an immune-mediated acute, systemic vasculitis and is the leading cause of acquired heart disease in children in the developed world. Bifidobacterium (BIF) is one of the dominant bacteria in the intestines of humans and many mammals and is able to adjust the intestinal flora disorder. The Caco-2 cell monolayers were treated with tumor necrosis factor-α (TNF-α) at 10 ng/ml for 24 h to induce the destruction of intestinal mucosal barrier system. Cells viability was detected through Cell Counting Kit-8 assay. Cell apoptosis was measured by flow cytometry and the expression of apoptosis related proteins was also detected through Western blot. The level of pro-inflammatory cytokines interleukin-6 (IL-6) and IL-8 was detected through ELISA, Western blot and qRT-PCR, respectively. Transepithelial electrical resistance (TEER) assay was conducted to value the barrier function of intestinal mucosa. Cell autophagy and NF-κB and p38MAPK pathways associated proteins were examined through Western blot. In the absence of TNF-α treatment, cell viability and apoptosis showed no significant change. TNF-α decreased cell viability and increased cell apoptosis and BIF treatment mitigated the TNF-α-induced change. Then, we found that BIF treatment effectively suppressed TNF-α-induced overexpression of IL-6 and IL-8. Besides, the results of TEER assay showed that barrier function of intestinal mucosa which was destroyed by TNF-α was effectively recovered by BIF treatment. In addition, TNF-α induced autophagy was also suppressed by BIF. Moreover, TNF-α activated NF-κB and p38MAPK signal pathways were also blocked by BIF, SN50 and SB203580. Our present study reveals that BIF plays a protective role in TNF-α-induced inflammatory response in Caco-2 cells through NF-κB and p38MAPK pathways.


Assuntos
Bifidobacterium , Mucosa Intestinal/metabolismo , Sistema de Sinalização das MAP Quinases , Síndrome de Linfonodos Mucocutâneos/prevenção & controle , NF-kappa B/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Células CACO-2 , Humanos , Inflamação/metabolismo , Inflamação/patologia , Inflamação/prevenção & controle , Mucosa Intestinal/patologia , Síndrome de Linfonodos Mucocutâneos/metabolismo , Síndrome de Linfonodos Mucocutâneos/patologia , Fator de Necrose Tumoral alfa/farmacocinética
5.
Echocardiography ; 36(7): 1357-1363, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31206770

RESUMO

BACKGROUND: Traditional X-ray-guided transcatheter closure of atrial septal defects (ASDs) via the right femoral vein carries a risk of radiation damage, which is greatly exacerbated by age and vascular conditions. Transesophageal echocardiography (TEE) guidance for the closure procedure not only broadens the indications of interventional therapy for ASDs but also avoids radiation exposure. PURPOSE: To assess the value of TEE-guided ASD device closure via the right internal jugular vein (RIJV) in children. METHODS: Nineteen pediatric patients with secondary ASD underwent TEE-guided ASD device closure via the RIJV from July 22, 2015 to July 19, 2017. After the RIJV was successfully accessed, one Fustar curve-adjustable delivery sheath was inserted. The implant depth was adjusted, and the tip of the sheath was curved to facilitate passage through the ASD for the delivery and release of the occluder. TEE was used to guide the entire procedure. RESULTS: In all 19 patients, the ASDs were successfully closed and the occluder was confirmed to have a stable position and good shape, with no residual shunt. During the follow-up period (2 months to 2 years), no pericardial effusion, thrombosis, tachyarrhythmia, atrioventricular block, or other complications were observed. CONCLUSIONS: An adjustable delivery sheath can be used to treat ASD via the RIJV. This procedure has varied indications, and its advantages include a short operation path, procedural accuracy, minimal trauma, and quick recovery, especially for young patients with large ASDs and cases in which a femoral vein approach is difficult. The procedure has great clinical significance and merits attention.


Assuntos
Ecocardiografia Doppler em Cores , Ecocardiografia Transesofagiana , Comunicação Interatrial/cirurgia , Dispositivo para Oclusão Septal , Ultrassonografia de Intervenção , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Veias Jugulares , Masculino
6.
Zhongguo Dang Dai Er Ke Za Zhi ; 20(12): 1030-1033, 2018 Dec.
Artigo em Zh | MEDLINE | ID: mdl-30572993

RESUMO

A retrospective analysis was performed for the clinical data of four children with Epstein-Barr virus (EBV)-related acute liver failure. There were two boys and two girls with a median age of 10 months (range 8.5-44 months). Of the four children, three were diagnosed with infectious mononucleosis (IM), among whom two met the diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH), and one was diagnosed with past EBV infection. All the children had positive EBV DNA in blood and all had pyrexia, hepatomegaly, and jaundice on admission. Three children had the symptom of splenomegaly, ascites, or vomiting. Two children had enlargement of cervical lymph nodes, skin rash, or pleural effusion. One child had gastrointestinal bleeding or stage 2 hepatic encephalopathy. All the children had an abnormal lymphocyte count of <10%, and only one child had leukocytosis and thrombocytopenia. Among the four children, alanine aminotransferase level increased by 10-100 times; total bilirubin level increased by 3-5 times; lactate dehydrogenase level increased by many 10 times; prothrombin time prolonged significantly. All the children were given antiviral therapy with intravenously injected acyclovir or ganciclovir, as well as hepatocyte growth factor to promote hepatocyte growth and hormone to alleviate inflammatory response. Two children were given plasma exchange in addition, among whom one was given the combination of continuous venovenous hemodiafiltration. Two children with HLH were given chemotherapy according to the HLH-2004 regimen. Three children survived, and one child with HLH died of multiple organ failure. It is concluded that EBV infection can cause acute liver failure and that early use of multimodality therapy including blood purification may be beneficial for prognosis in these children.


Assuntos
Infecções por Vírus Epstein-Barr , Falência Hepática Aguda , Pré-Escolar , Feminino , Herpesvirus Humano 4 , Humanos , Lactente , Linfo-Histiocitose Hemofagocítica , Masculino , Estudos Retrospectivos
7.
Zhongguo Dang Dai Er Ke Za Zhi ; 19(8): 904-907, 2017 Aug.
Artigo em Zh | MEDLINE | ID: mdl-28774366

RESUMO

OBJECTIVE: To investigate the association between rs9722 polymorphisms in the S100B gene and hand, foot and mouth disease (HFMD) caused by enterovirus 71. METHODS: A total of 124 HFMD children with enterovirus 71 infection were enrolled as subjects, and 56 healthy children were enrolled as control group. The rs9722 polymorphisms in the S100B gene were detected for both groups, and the serum level of S100B protein was measured for 74 HFMD children. RESULTS: The rs9722 locus of the S100B gene had three genotypes, CC, CT, and TT, and the genotype frequencies were in accordance with Hardy-Weinberg equilibrium. Compared with the control group, the HFMD group had significant increases in the frequencies of TT genotype and T allele (P<0.01). Children with severe HFMD caused by enterovirus 71 infection had significantly higher frequencies of TT genotype and T allele than those with moderate or mild HFMD (P<0.05). Compared with the cured patients, the patients with poor prognosis had significant increases in the frequencies of TT genotype and T allele in the rs9722 locus of the S100B gene (P<0.05). Among the 74 children with HFMD, the children with TT genotype had the highest serum level of S100B protein, and those with CC genotype had the lowest level (P<0.01). CONCLUSIONS: T allele in the rs9722 locus of the S100B gene might be a risk factor for severe HFMD caused by enterovirus 71 infection.


Assuntos
Enterovirus Humano A , Infecções por Enterovirus/complicações , Doença de Mão, Pé e Boca/genética , Polimorfismo Genético , Subunidade beta da Proteína Ligante de Cálcio S100/genética , Pré-Escolar , Feminino , Genótipo , Doença de Mão, Pé e Boca/etiologia , Humanos , Lactente , Masculino
8.
Front Cardiovasc Med ; 10: 1083188, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37008326

RESUMO

Dilated cardiomyopathy (DCM) is one of the leading causes of heart failure in children with diverse clinical characteristics. To date, DCM with a giant atrium as the first manifestation is rare and has not been reported in previous literature. We report a case of a male infant born with a significantly enlarged right atrium. Due to worsened clinical symptoms and the risk of arrhythmias and thrombosis, we performed the surgical reduction of the right atrium. Unfortunately, DCM and a progressive re-enlargement of the right atrium appeared during midterm follow-up. The mother's echocardiogram also suggested DCM, and the patient was eventually considered for a diagnosis of familial DCM. This case may expand the clinical spectrum of DCM and reminds us of the importance of good follow-up of children with idiopathic dilatation of the right atrium.

9.
Oxid Med Cell Longev ; 2022: 8494076, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35707277

RESUMO

Methods: The clinical GGT data from 168,858 patients with 44 diseases and 132,357 healthy control in the clinical laboratory of our hospital over the past five years were retrieved. All data were analyzed with SPSS, RStudio V.1.3.1073, and python libraries 3.8. Results: Thirty-eight out of 44 diseases had significantly increased (p < 0.001) circulating GGT activities, whereas gastric cancer, anemia, renal cyst, cervical cancer, preeclampsia, and knee-joint degenerative diseases had significantly decreased (p < 0.001) GGT activities compared to the healthy control. ROC analyses showed that GGT was an excellent biomarker for liver cancer (AUC = 0.86), pancreatitis (AUC = 0.84), or hepatic encephalopathy (AUC = 0.80). All pancreas-related diseases had more than 8-fold increases in GGT activity span than the healthy control, while pancreatic cancer had a 12-fold increase (1021 U/L vs. 82 U/L). The knee-joint degenerative disease had the lowest median and narrowest GGT activity range (63 U/L). Furthermore, most diseases' lowest to highest GGT activities were beyond the healthy control in both directions. Conclusions: Thirty-eight out of 44 diseases were in overall oxidative states defined by the increased GGT median values. In contrast, knee-joint degenerative disease, gastric cancer, anemia, renal cyst, cervical cancer, and preeclampsia were in overall antioxidative states. Moreover, most diseases swing between oxidative and antioxidative states, evidenced by the increased lowest to highest GGT activity ranges than the healthy control. Liver- and pancreas-related abnormalities were responsible for significantly increased GGT activities. Our overall results suggested that circulating GGT was a redox status biomarker.


Assuntos
Doenças Renais Císticas , Neoplasias Renais , Pré-Eclâmpsia , Neoplasias do Colo do Útero , Biomarcadores , Feminino , Humanos , Oxirredução , Estudos Retrospectivos , gama-Glutamiltransferase
10.
Front Pharmacol ; 13: 903488, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833019

RESUMO

Background: A high prevalence of infantile-onset Pompe disease (IOPD) in the Chinese population has been noted, but there are currently no reported clinical trials of enzyme replacement therapy (ERT) for IOPD in this population. The purpose of this study was to evaluate the efficacy and safety of alglucosidase alfa in Chinese patients with IOPD. Materials and Methods: A multicentre, single-arm, prospective, open-label clinical trial was performed at 4 sites in China. Eligible Chinese subjects with IOPD received an infusion of alglucosidase alfa at a dose of 20 mg/kg every 2 weeks for up to 52 weeks. The primary endpoints of clinical efficacy were the survival rate and changes in the left ventricular mass index (LVMI). The safety assessment was based on the incidence of adverse events (AEs). Results: A total of 10 eligible subjects were enrolled in the study. The mean age at the start of ERT was 5.36 ± 1.56 months. Nine subjects had survived after 52 weeks of treatment. One subject discontinued the study and died after mechanical ventilation was withdrawn. The intent-to-treat analysis demonstrated that the survival rate was 90.0% (95% confidence interval: 55.5-99.7%). The mean LVMI at week 52 was 70.59 ± 39.93 g/m2 compared to that of 298.02 ± 178.43 g/m2 at baseline, with a difference of -227.60 ± 155.99 g/m2. All subjects had left ventricular mass (LVM) Z scores >10 at baseline, and eight subjects (80%) achieved Z scores <5 at week 52. No treatment-related AEs were observed, and no AEs led to the discontinuation of treatment. Conclusions: This clinical trial is the first study of ERT for IOPD in China, indicating that alglucosidase alfa has favourable efficacy and safety for the treatment of Chinese patients with IOPD (ClinicalTrials.gov number, NCT03687333).

11.
Front Pediatr ; 9: 639687, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34164355

RESUMO

Sengers syndrome (OMIM #212350) is a rare autosomal recessive disorder due to mutations in acylglycerol kinase (AGK) gene. We report two cases that were diagnosed clinically and confirmed genetically. Both infants had typical clinical features characterized by hypertrophic cardiomyopathy, bilateral cataracts, myopathy, and lactic acidosis, and heart failure was the most severe manifestation. Genetic testing of a boy revealed a homozygous pathogenic variant for Sengers syndrome in AGK (c.1131+2T>C) which was classified as likely pathogenic according to the ACMG guideline; besides, his skeletal muscle biopsy and transmission electron microscope presented obvious abnormity. One girl had compound heterozygous (c.409C>T and c.390G>A) variants of AGK gene that was identified in the proband and further Sanger sequencing indicated that the parents carried a single heterozygous mutation each. After the administration of "cocktail" therapy including coenzyme Q10, carnitine, and vitamin B complex, as well as ACEI, heart failure and myopathy of the boy were significantly improved and the condition was stable after 1-year follow-up, while the cardiomyopathy of the girl is not progressive but the plasma lactate acid increased significantly. We present the first report of two infants with Sengers syndrome diagnosed via exome sequencing in China.

12.
Biofactors ; 46(3): 465-474, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31889348

RESUMO

Long noncoding RNA myocardial infarction-associated transcript 2 (lncRNA Mirt2) is a burgeoning lncRNA, its anti-inflammatory capacity has been testified. Nonetheless, the functions of Mirt2 in immunoglobulin A nephropathy are unexplored. We tried to impart the influences of Mirt2 in lipopolysaccharide (LPS)-evoked HK-2 cells damage. HK-2 cells were manipulated with 10 ng/ml LPS, next cell viability, apoptosis, reactive oxygen species (ROS) generation, pro-inflammatory factors and Mirt2 expression were evaluated. After pc-Mirt2 vector transfection, the aforementioned trials were performed. Meanwhile, real-time quantitative polymerase chain reaction (PCR) experiment was used to detect miR-126 expression. Subsequently, functions of miR-126 in LPS-treated HK-2 cells were further delved after transfection with miR-126 mimic. Western blot was used to evaluate NF-κB pathway. The data showed that LPS invoked HK-2 cells inflammatory damage via the suppression of cell viability and the acceleration of apoptosis, ROS level, and IL-1ß and IL-6 secretion. LPS inhibited Mirt2 expression and overexpression of Mirt2 mitigated LPS-caused inflammatory damage in HK-2 cells. Additionally, overexpression of Mirt2 repressed miR-126 expression in LPS-stimulated cells. Meanwhile the anti-inflammatory effect of Mirt2 was inverted by upregulating miR-126 expression. Besides, overexpressed Mirt2 retarded LPS-activated NF-κB pathway via repressing miR-126. The research certified the anti-inflammatory impacts of Mirt2 on LPS-impaired HK-2 cells.


Assuntos
Inflamação/genética , Inflamação/prevenção & controle , MicroRNAs/genética , RNA Longo não Codificante/genética , Apoptose/genética , Linhagem Celular , Sobrevivência Celular/genética , Células Cultivadas , Humanos , Lipopolissacarídeos , Transdução de Sinais
13.
Front Pediatr ; 7: 465, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31824893

RESUMO

Objective: To describe the clinical characteristics of maternal autoantibody-mediated arrhythmia and/or cardiomyopathy, and to explore the therapeutic role of glucocorticoids in these diseases. Methods: This was a retrospective observational study of 2 fetuses and 14 children who presented with autoantibody-mediated arrhythmia and/or cardiomyopathy in our hospital from September 2010 to December 2018. Results: In total, 16 patients were identified, including 2 fetuses, and 14 children. One mother suffered from Sjogren's syndrome, two suffered from systemic lupus erythematosus (SLE), and the remaining 13 were asymptomatic carriers of autoantibodies. Two fetuses were diagnosed with complete congenital heart block (CHB) and had mean heart rates of 45 and 50 bpm. In the 14 surviving children, third-degree CHB was detected in 4 children, second- to third-degree CHB in 4, corrected QT interval (QTc) prolongation in 1, atrioventricular dissociation, and junctional ectopic tachycardia in 1, complete left bundle branch block (CLBBB) with dilated cardiomyopathy (DCM) in 3, and endocardial fibroelastosis (EFE) in 1. All of the 14 surviving babies received intravenous immunoglobulin and glucocorticoids. None of the children received pacemaker implantation. During the follow-up, one 3-month-old girl who had complete CHB, DCM, and Torsades de pointes almost recovered after the administration of prednisone for ~8 years. Three cases with complete CHB had no improvement after 3-5 years of follow-up. One case with EFE and three cases with CLBBB and DCM were in stable condition now. Children with QTc prolongation and junctional ectopic tachycardia returned to a regular rhythm. Conclusions: Autoantibody-mediated arrhythmias and/or cardiomyopathy are severe complications related to maternal autoantibodies, and the administration of steroid may be beneficial in reversing complete CHB.

14.
World J Pediatr ; 15(3): 255-261, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31020541

RESUMO

BACKGROUND: Recurrent respiratory tract infection (RRTI) is a disease occurred frequently in preschool children. METHODS: A total of 120 RRTI children were randomly divided into active group, remission group, intervention group and control group, meanwhile 30 healthy children were selected as the healthy group. Children in the intervention group were given oral Bifidobaeterium tetravaccine tablets (Live) for 2 months, while the control group received routine treatment. Stool sample were detected to analyze the bacterial strains. The occurrence of respiratory tract infection (RTI) was compared between different groups during 1 year follow-up. RESULTS: Compared with the healthy group, the number of Bifidobacteria and Lactobacilli in the active group, remission group, intervention group and control group was significantly decreased (P < 0.05). The number of Bifidobacteria and Lactobacilli in the intervention group was significantly higher compared to other RRTI groups (P < 0.05). During the follow-up period, the average annual frequency of different acute RTI and use of antibiotics were significantly reduced (P < 0.05), the average duration of cough, fever and use of antibiotics at each episode were also significantly shortened (P < 0.05) in the intervention group compared to the control group. CONCLUSIONS: Children with RRTI are susceptible to intestinal flora imbalance. Oral probiotics can effectively improve the RRTI intestinal microecological balance in children and reduce the frequency of RTI.


Assuntos
Microbioma Gastrointestinal , Probióticos/uso terapêutico , Infecções Respiratórias/prevenção & controle , Bifidobacterium/isolamento & purificação , Criança , Pré-Escolar , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Feminino , Humanos , Lactobacillus/isolamento & purificação , Masculino
15.
Stem Cell Res Ther ; 8(1): 18, 2017 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-28129792

RESUMO

BACKGROUND: Stem cells provide a promising candidate for the treatment of the fatal pediatric dilated cardiomyopathy (DCM). This study aimed to investigate the effects of intramuscular injection of human umbilical cord-derived mesenchymal stem cells (hUCMSCs) on the cardiac function of a DCM rat model. METHODS: A DCM model was established by intraperitoneal injections of doxorubicin in Sprague-Dawley rats. hUCMSCs at different concentrations or cultured medium were injected via limb skeletal muscles, with blank medium injected as the control. The rats were monitored for 4 weeks, meanwhile BNP, cTNI, VEGF, HGF, GM-CSF, and LIF in the peripheral blood were examined by ELISA, and cardiac function was monitored by echocardiography (Echo-CG). Finally, the expression of IGF-1, HGF, and VEGF in the myocardium was examined by histoimmunochemistry and real-time PCR, and the ultrastructure of the myocardium was examined by electron microscopy. RESULTS: Injection of hUCMSCs markedly improved cardiac function in the DCM rats by significantly elevating left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS). The BNP and cTNI levels in the peripheral blood were reduced by hUCMSCs, while HGF, LIF, GM-CSF, and VEGF were increased by hUCMSCs. Expression of IGF-1, HGF, and VEGF in the myocardium from the DCM rats was significantly increased by hUCMSC injection. Furthermore, hUCMSCs protected the ultrastructure of cardiomyocytes by attenuating mitochondrial swelling and maintaining sarcolemma integrity. CONCLUSIONS: Intramuscular injection of UCMSCs can improve DCM-induced cardiac function impairment and protect the myocardium. These effects may be mediated by regulation of relevant cytokines in serum and the myocardium.


Assuntos
Cardiomiopatia Dilatada/terapia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/metabolismo , Recuperação de Função Fisiológica/fisiologia , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Animais , Cardiomiopatia Dilatada/genética , Cardiomiopatia Dilatada/metabolismo , Cardiomiopatia Dilatada/patologia , Sangue Fetal/citologia , Sangue Fetal/metabolismo , Regulação da Expressão Gênica , Fator Estimulador de Colônias de Granulócitos e Macrófagos/sangue , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Fator de Crescimento de Hepatócito/sangue , Fator de Crescimento de Hepatócito/genética , Humanos , Injeções Intramusculares , Fator de Crescimento Insulin-Like I/genética , Fator de Crescimento Insulin-Like I/metabolismo , Fator Inibidor de Leucemia/sangue , Fator Inibidor de Leucemia/genética , Masculino , Células-Tronco Mesenquimais/citologia , Mitocôndrias Cardíacas/metabolismo , Mitocôndrias Cardíacas/patologia , Miocárdio/metabolismo , Miocárdio/patologia , Peptídeo Natriurético Encefálico/sangue , Peptídeo Natriurético Encefálico/genética , Ratos , Ratos Sprague-Dawley , Transplante Heterólogo , Troponina I/sangue , Troponina I/genética , Fator A de Crescimento do Endotélio Vascular/sangue , Fator A de Crescimento do Endotélio Vascular/genética
16.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 23(12): 891-4, 2003 Dec.
Artigo em Zh | MEDLINE | ID: mdl-14714355

RESUMO

OBJECTIVE: To evaluate the effect of Milkvetch Injection (MI) on cardiac function and hemodynamics in children with tetralogy of Fallot after radical operation. METHODS: Thirty-two children with tetralogy of Fallot were divided into two groups, the 20 patients in the control group treated with conventional treatment and the 12 patients in the treated group treated with 15 ml of MI every 12 hrs for 7 days. The cardiac function and hemodynamic parameters were determined by echocardiography and thermodilution catheter inserted in pulmonary artery. RESULTS: Patients' cardiac function and hemodynamic parameters were improved significantly 1 hr after administering 15 ml of MI Injection, but restored to the level before medication in 2-4 hrs. Administering MI injection for successive 7 days could gradually improve patients' cardiac function and hemodynamic parameters after operation, and the improvement became more evident with the prolonging time of medication. The intubation time, intensive care unit duration and the time of intravenously administration of inotropic drugs in the treated group were significantly shorter than those in the control group (P < 0.01). CONCLUSION: MI could significantly improve the hemodynamics and cardiac function, and shorten the recovery time in children with tetralogy of Fallot after radical operation.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fitoterapia , Tetralogia de Fallot/cirurgia , Função Ventricular , Astrágalo , Astragalus propinquus , Criança , Pré-Escolar , Feminino , Hemodinâmica , Humanos , Masculino , Período Pós-Operatório , Tetralogia de Fallot/tratamento farmacológico , Tetralogia de Fallot/fisiopatologia
17.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 24(7): 596-600, 2004 Jul.
Artigo em Zh | MEDLINE | ID: mdl-15307696

RESUMO

OBJECTIVE: To evaluate the effect of milkvetch injection (MI) on immune function of children with tetralogy of Fallot (TOF) after radical operation. METHODS: Forty-children with TOF were divided into two groups, the 20 in the control group treated with conventional treatment alone and the 20 in the treated group treated with conventional treatment plus 15 ml of MI every 12 hrs for 14 days. Changes of immunoglobulin, complements, lymphocyte phenotypes and cytokines were observed. RESULTS: In the treated group, the abnormally increased levels of IgG, IgM, C3, C4, CD8+ and CD19+ began to lower at lst-2nd week after treatment, and basically restored to the levels of normal at 3rd-4th week; while the decreased levels of IgA, CD3+, CD4+, CD4+/CD8+ ratio, CD3+/HLA-DR+ and CD3+/CD16+ -CD56+ raised gradually from the 1st week and restored to normal range at 2nd-3rd week. The IL-6 and tumor necrosis factor-alpha (TNF-alpha) levels in the plasma and supernatant, produced in vitro by peripheral blood mononuclear cells (PBMC) decreased gradually at 1st week and restored to the normal level at 3rd-4th weeks. The different value before and after treatment of the above-mentioned indexes in the treated group were superior to those in the control group (P<0.05 or P<0.01). CONCLUSION: MI could significantly improve the immune function of children with TOF after radical operation.


Assuntos
Adjuvantes Imunológicos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Fitoterapia , Tetralogia de Fallot/tratamento farmacológico , Tetralogia de Fallot/imunologia , Astrágalo , Astragalus propinquus , Relação CD4-CD8 , Ponte Cardiopulmonar , Criança , Pré-Escolar , Complemento C4/metabolismo , Feminino , Humanos , Imunoglobulina G/sangue , Infusões Intravenosas , Masculino , Período Pós-Operatório , Tetralogia de Fallot/cirurgia , Fator de Necrose Tumoral alfa/metabolismo
18.
Acta Pharmacol Sin ; 23(10): 898-904, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12370095

RESUMO

AIM: To explore the effects of astragaloside IV (XGA) on myocardial calcium transport and cardiac function in ischemic rats. METHODS: Eighty-four Wistar rats were divided into three groups: control group (n=12); ischemic group (n=12) was given isoprenaline injection sc at a dose of 30 mg/kg; and XGA group (n=60) was given XGA after isoprenaline administration. The changes of the parameters of hemodynamics, cardiac function, and intra- and extracellular calcium concentration of the myocardial cells were determined. The dose- and time-effect relationship of XGA on myocardial calcium transport and cardiac function were observed. RESULTS: After XGA administration, there was significant improvement in cardiac function and hemodynamics in ischemic rats. The cardiac output, heart rate, stroke volume, mean aortic pressure, systolic aortic pressure, the stroke work of left ventricule, the right and left ventricle systolic pressure, and +dp/dt of the right ventricle of ischemic rats gradually recovered to the level of the control group with increasing the dose of XGA and prolongation of the action of XGA. The ionized calcium of the myocardium and the total amount of calcium of the myocardial tissue decreased markedly compared to those in ischemic group, and the activity of calcium pump of erythrocyte membrane increased significantly in comparison to that of ischemic group, but their changes had no trend of increase with increasing dose of the XGA. However, there was a gradual decrease of the ionized calcium of the myocardium with the prolongation of acting time of XGA. CONCLUSION: XGA improves the cardiac function in ischemic rats, and the reduction of excessive accumulation of intracellular calcium within myocardial cells plays an important role.


Assuntos
Cálcio/metabolismo , Débito Cardíaco/efeitos dos fármacos , Isquemia Miocárdica/metabolismo , Saponinas/farmacologia , Triterpenos/farmacologia , Animais , Transporte Biológico Ativo , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Hemodinâmica/efeitos dos fármacos , Masculino , Isquemia Miocárdica/fisiopatologia , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Ratos , Ratos Wistar , Saponinas/uso terapêutico , Triterpenos/uso terapêutico
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