[A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children].

OBJECTIVE: To analyze the disease spectrums underlying orthostatic intolerance (OI) and sitting intolerance (SI) in Chinese children, and to understand the clinical empirical treatment options. METHODS: The medical records including history, physical examination, laboratory examination, and imagological examination of children were retrospectively studied in Peking University First Hospital from 2012 to 2021. All the children who met the diagnostic criteria of OI and SI were enrolled in the study. The disease spectrums underlying OI and SI and treatment options during the last 10 years were analyzed. RESULTS: A total of 2 110 cases of OI and SI patients were collected in the last 10 years, including 943 males (44.69%) and 1 167 females (55.31%) aged 4－18 years, with an average of (11.34±2.84) years. The overall case number was in an increasing trend over the year. In the OI spectrum, postural tachycardia syndrome (POTS) accounted for 826 cases (39.15%), followed by vasovagal syncope (VVS) (634 cases, 30.05%). The highest proportion of SI spectrum was sitting tachycardia (STS) (8 cases, 0.38%), followed by sitting hypertension (SHT) (2 cases, 0.09%). The most common comorbidity of OI and SI was POTS coexisting with STS (36 cases, 1.71%). The highest proportion of treatment options was autonomic nerve function exercise (757 cases, 35.88%), followed by oral rehydration salts (ORS) (687 cases, 32.56%), metoprolol (307 cases, 14.55%), midodrine (142 cases, 6.73%), ORS plus metoprolol (138 cases, 6.54%), and ORS plus midodrine (79 cases, 3.74%). The patients with POTS coexisting with VVS were more likely to receive pharmacological intervention than the patients with POTS and the patients with VVS (41.95% vs. 30.51% vs. 28.08%, χ2= 20.319, P < 0.01), but there was no significant difference in the proportion of treatment options between the patients with POTS and the patients with VVS. CONCLUSION: POTS and VVS in children are the main underlying diseases of OI, while SI is a new disease discovered recently. The number of children with OI and SI showed an increasing trend. The main treatment methods are autonomic nerve function exercise and ORS. Children with VVS coexisting with POTS were more likely to take pharmacological treatments than those with VVS or POTS only.

[Progress in diagnosis and management of syncope in children].

Syncope is a common emergency of children and adolescents, which has serious influence on the quality of life. Neurally-mediated syncope, including postural tachycardia syndrome, vasovagal syncope, orthostatic hypotension and orthostatic hypertension, is the main cause of syncope in children and adolescents. The main manifestations of neurally-mediated syncope are diverse, such as dizziness, headache, chest tightness, chest pain, pale complexion, fatigue, pre-syncope and syncope. Although the clinical manifestations are similar, each subtype of syncope has its hemodynamic feature and optimal treatment option. The diagnosis rate of syncope in children has been greatly improved on account of the development of the diagnostic procedures and methods. In recent years, with the promotion of head-up tilt test and drug-provocated head-up tilt test, the hemodynamic classification of neurally-mediated syncope gets continually refined. In recent years, with the effort of clinicians, an appropriate diagnostic protocol for children with syncope has been established. The initial evaluation consists of history taking, physical examination, standing test and standard electrocardiography. After the initial evaluation, some patients could be diagnosed definitely, such as postural tachycardia syndrome, orthostatic hypotension, and situational syncope. Those with a specific entity causing syncope need selective clinical and laboratory investigations. Patients for whom the cause of syncope remained undetermined should undergo head-up tilt test. The precise pathogenesis of neurally-mediated syncope is not entirely clear. In recent years, studies have shown that neurally-mediated syncope may be related to several factors, including hypovolemia, high catecholamine status, abnormal local vascular tension, decreased skeletal muscle pump activity and abnormal neurohumoral factors. Currently based on the possible pathogenesis, the individualized treatment of neurally-mediated syncope has also been studied in-depth. Generally, the management of neurally-mediated syncope includes non-pharmacological and pharmacological interventions. Patient education is the fundamental part above all. In addition to exercise training, the first-line treatments mainly include oral rehydration salts, beta adrenoreceptor blockers, and alpha adrenoreceptor agonists. By analyzing the patient's physiological indexes and biomarkers before treatment, the efficacy of medication could be well predicted. The individualized treatment will become the main direction in the future researches.

[Epidemiological characteristics and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City].

OBJECTIVE: To investigate the prevalence and influencing factors of Blastocystis hominis infection among children with diarrhea under five years of age in Guangzhou City. METHODS: Children with diarrhea under 5 years of age admitted to Guangzhou Children's hospital, Guangzhou Maternity and Child Healthcare Hospital and Guangzhou Women and Children's Medical Center during the period between January 1 and December 31, 2020, were enrolled. Participants' demographics, living environments and health status were collected using questionnaire surveys. Stool samples were collected from participants and nucleic acid was extracted. B. hominis infection was identified using PCR assay and sequence alignment, and the factors affecting B. hominis infection among children with diarrhea under 5 years of age were identified using univariate analysis and multivariate logistic regression analysis. RESULTS: A total of 684 children with diarrhea under 5 years of age were enrolled, including 468 male children and 216 female children, with a mean age of (1.79 ± 1.12) years. The overall prevalence of B. hominis infection was 4.97% [34/684, 95% confidential interval (CI): (3.59%, 6.86%)] among participants, and there was no significant difference in the prevalence of B. hominis infection between children with chronic [7.52% (20/266), 95% CI: (4.92%, 11.33%)] and acute diarrhea [3.35% (14/418), 95% CI: (2.01%, 5.54%)] (χ2 = 5.983, P = 0.014). Multivariate logistic regression analysis identified keeping pet [odds ratio (OR) = 6.298, 95% CI: (2.711, 14.633)], drinking non-tap water [OR = 4.522, 95% CI: (1.769, 11.561)], lactose intolerance [OR = 4.221, 95% CI: (1.043, 17.087)], antibiotic use [OR = 0.125, 95% CI: (0.017, 0.944)] and chronic diarrhea [OR = 2.172, 95% CI: (1.018, 4.637)] as factors affecting B. hominis infection among children with diarrhea under 5 years of age in Guangzhou City. CONCLUSIONS: B. hominis infections is detected in children with diarrhea under five years of age in Guangzhou City. Improving home environments and pet-keeping hygiene is recommended to reduce the likelihood of B. hominis infection among children.

The up-regulated lncRNA DLX6-AS1 in colorectal cancer promotes cell proliferation, invasion and migration via modulating PI3K/AKT/mTOR pathway.

OBJECTIVE: Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths around the world. Recently, using the high-throughput techniques, long non-coding RNAs (lncRNAs) have been shown to play an important role in CRC progression. In the present study, we aimed to determine lncRNA DLX6 Antisense RNA 1 (DLX6-AS1) in CRC tissues and cell lines and to investigate the molecular mechanisms of DLX6-AS1 in CRC progression. PATIENTS AND METHODS: Quantitative real-time PCR was performed to detect gene expression; cell counting kit-8, colony formation, cell invasion, and migration assays were performed to determine cell proliferation, invasion, and migration, respectively; caspase-3 activity assay kit was used to detect caspase-3 activity; in vivo tumor growth was evaluated in a nude mice xenograft model. RESULTS: DLX6-AS1 was up-regulated in 60 CRC tissues when compared to normal adjacent colorectal tissues, and high expression of DLX6-AS1 was correlated with advanced T stage and distant metastasis in CRC patients. The up-regulation of DLX6-AS1 was further confirmed in CRC cell lines. The gain-of-function assays showed that DLX6-AS1 overexpression promoted HCT116 cell proliferation, invasion, and migration, but inhibited cell apoptosis; while the loss-of-function assays showed that DLX6-AS1 knockdown exerted the opposite effects in SW480 cells. In vivo studies revealed that DLX6-AS1 knockdown suppressed tumor growth in the nude mice xenograft model. In addition, DLX6-AS1 overexpression caused an increase in the phosphorylated phosphoinositide 3-kinase (p-PI3K), p-AKT and p-mammalian target of rapamycin (mTOR) protein levels, and DLX6-AS1 knockdown had the opposite effects. Blockade of PI3K/AKT/mTOR signalling pathway by using mTOR inhibitor partially abolished the enhanced effects of DLX6-AS1 overexpression on CRC cell proliferation and metastasis. CONCLUSIONS: In summary, our data indicated that DLX6-AS1 promoted CRC cell proliferation, invasion, and migration but inhibited cell apoptosis via targeting PI3K/AKT/mTOR signalling pathway, suggesting the key role of DLX6-AS1 in CRC progression.

[Clinical analysis of transnasal endoscopic repair of cerebrospinal fluid rhinorrhea].

Objective:To summarize the common clinical types of cerebrospinal fluid（CSF） rhinorrhea and key points of transnasal endoscopic repair of CSF rhinorrhea. To evaluate clinical effects. Method:In 29 patients with cerebrospinal fluid rhinorrhea, 9 patients with traumatic CSF rhinorrhea, 10 patients with spontaneous CSF rhinorrhea, 7 patients with CSF rhinorrhea after tumour excision, and 3 patients with iatrogenic CSF rhinorrhea. All the 29 patients were treated with transnasal endoscopic repair of CSF rhinorrhea. Result:There were 25 patients were successfully repaired at one time. Three patients developed intracranial infection and 2 patient developed pneumocephalus after surgery, all of them were cured with conservative treatment. All the patients who were followed-up for more than half a year had no recurrence. Conclusion:Transnasal endoscopic repair of CSF rhinorrhea is safe and effective, the success rate of operation is high, it is not easy to recur, and the complications are few. It can be used as the first choice for repairing of CSF rhinorrhea and effective prevention measures. Accurate location of leak, appropriate repair, effective reconstruction of the skull base, continuous drainage of the lumbar cistern when necessary and active prevention of intracranial infection are critical to the success of operation.

[Analysis of clinical features of respiratory epithelial adenomatoid hamartoma in the nasal cavity].

Objective: To analyze the clinical features of respiratory epithelial adenomatoid hamartoma (REAH) in the nasal cavity. Methods: Clinical datas of 23 patients, who were hospitalized in Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, from February 2016 to February 2018 with histopathologically proved REAH in the nasal cavity were reviewed. There were 18 males and 5 females, with the age range from 16 to 71 years old. The most common area, main symptoms, surgical methods and follow-up results were analyzed. Results: The most common area was olfactory cleft (21 cases), and the mainly symptom was nasal congestion (18 cases). All the patients received transnasal endoscopic surgery and had no recurrence during following-up from three months to one year. Conclusions: The most common area of REAH in the nasal cavity is the olfactory cleft. Histopathological result is needed to make a definite diagnosis. Complete surgical resection is the main treatment.

Decompression of tension pneumothoraces in Asian trauma patients: greater success with lateral approach and longer catheter lengths based on computed tomography chest wall measurements.

INTRODUCTION: Our study aims to compare the anterior and lateral approaches for needle thoracostomy (NT) and determine the adequacy of catheter lengths used for NT in Asian trauma patients based on computed tomography chest wall measurements. METHODOLOGY: A retrospective review of chest computed tomography scans of 583 Singaporean trauma patients during period of 2011-2015 was conducted. Four measurements of chest wall thickness (CWT) were taken at the second intercostal space, midclavicular line and fifth intercostal space, midaxillary line bilaterally. Measurements were from the superficial skin layer of the chest wall to the pleural space. Successful NT was defined radiologically as CWT ≤ 5 cm. RESULTS: There were 593 eligible subjects. Mean age was 49.1 years (49.1 ± 21.0). Majority were males (77.0%) and Chinese (70.2%). Mean CWT for the anterior approach was 4.04 cm (CI 3.19-4.68) on the left and 3.92 cm (CI 3.17-4.63) on the right. Mean CWT for the lateral approach was 3.52 cm (CI 2.52-4.36) on the left, and 3.62 cm (CI 3.65-4.48) on the right. Mean CWT was shorter in the lateral approach by 0.52 cm on the left and 0.30 cm on the right (p = 0.001). With a 5.0 cm catheter in the anterior approach, 925 out of 1186 sites (78.8%) will have adequate NT as compared to 98.2% with a 7.0 cm catheter. Similarly, in the lateral approach 1046 out of 1186 (88.2%) will have adequate NT as compared to 98.5% with a 7.0 cm catheter. Obese subjects had significantly higher mean CWT in both approaches (p = 0.001). There was moderate correlation between BMI and CWT in the anterior approach, r 2 = 0.529 as compared to the lateral approach, r 2 = 0.244. CONCLUSION: Needle decompression using the lateral approach or a longer catheter is more likely to succeed in Asian trauma patients. A high BMI is an independent predictor of failure of NT, especially for the anterior as compared to lateral approach.

miR-340 suppresses tumor growth and enhances chemosensitivity of colorectal cancer by targeting RLIP76.

OBJECTIVE: Colorectal cancer (CRC) is a common human malignancy and is the second leading cause of cancer deaths worldwide with a dismal prognosis. Previous investigations have shown that miR-340 can modulate the metabolism of CRC cells. The aim of this report is to study the role of miR-340 in the development and progression of CRC. PATIENTS AND METHODS: The level of miR-340 in CRC cells was determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting. CRC cell lines were used as model cell lines and the anti-tumor effect of miR-340 in vitro was examined. The luciferase reporter assay was performed. The level of miR-340 was restored in CRC cells by the usage of the miR-340 mimic. Re-expression of RLIP76 in CRC cells was then constructed. Moreover, the target gene of miR-340 was identified through the experiment of in vivo xenograft model. RESULTS: The aberrant downregulation of miR-340 is correlated with advanced stage of CRC. Furthermore, the ectopic overexpression of miR-340 in CRC cell lines resulted in growth inhibition, apoptosis and enhanced chemosensitivity in vitro and in vivo, which was mediated by directly targeting RLIP76. CONCLUSIONS: miR-340 acts as a tumor suppressor in CRC and is involved in the chemoresistance of CRC.

Methylation of DAPK1 promoter: frequent but not an adverse prognostic factor in myelodysplastic syndrome.

Promoter hypermethylation plays an important role in the inactivation of cancer-related genes. This abnormality occurs early in leukemogenesis and seems to be associated with poor prognosis in myelodsplastic syndrome (MDS). The identification of more inactivated tumor suppressor genes contributing to the development of MDS may lead to further elucidation of the biology of this disease and help to identify novel targets for therapy. In this study, the methylation status of death-associated protein kinase 1 (DAPK1) gene promoter was analyzed by using methylation-specific polymerase chain reaction in bone marrow (BM) samples from 59 patients with different stages of MDS. The abnormal methylation of the DAPK1 gene was found in 37 of 59 (62.7%) MDS cases. The correlation was significant between the sex and the methylation status of DAPK1 promoter in MDS patients (R=0.332, P=0.010). Furthermore, methylation status of DAPK1 promoter was associated with the percentage of BM blasts (R=0.346, P=0.010) and International Prognosis Scoring System (IPSS) groups (R=0.278, P=0.034). The estimated 50% survival time of the methylated DAPK1 group and unmethylated group was 20 and 33 months, respectively. There was no significant difference between these two groups (chi2=0.652, P=0.419). Multivariate analysis identified the age older than 50 years, the Int-2/high-risk categories of IPSS and the advanced stage MDS (RAEB-1/RAEB-2) in WHO classification as negative prognostic factors (P<0.05). Aberrant methylation of DAPK1 gene promoter had no influence on the prognosis of MDS despite of its increasing occurrence during disease progression.

Computational study of the proton transfer of phenyl urea.

The proton transfer between two nitrogen atoms (N1 and N3) in a molecule of phenyl urea is an important process in the synthesis of 1-phenylimidazolidine-2,4-dione. Three pathways of the proton transfer have been investigated using Density Functional Theory (DFT). With negative N1 phenyl urea, the transformed double bond of N1-C2 connects N1, C2, and N3 into a benzene conjugate system, making the structure more stable than negative N3 phenyl urea. Intermolecular proton transfer was found to be the primary manner of protein transfer at 300 K. Both negative N1 and negative N3 exist and the former is primal. The proton transfer is very fast, and the diluted solution may slow down the rate but produce much more negative N1 as well.

Synthesis and reaction mechanism of 3-(4-methoxyphenylazo)acrylic acid.

Using 4-methoxylphenylhydra zine hydrochloride (1a) as starting material, 2-[2-(4-methoxyphenyl) hydrazono] acetic acid (2a) was prepared after treatment with 1 equivalent of 2-oxoacetic acid, and 3-(4-methoxyphenyldiazo) acrylic acid (3a) was obtained with 2 equivalents of 2-oxoacetic acid through a novel reaction. The mechanism of reaction was analyzed with the help of charge distribution computation. This suggests that the novel reaction depends on the electronegativity of C9, which can be mainly affected by the substituents of the benzene ring.

SATB1 regulates SPARC expression in K562 cell line through binding to a specific sequence in the third intron.

Special AT-rich binding protein 1 (SATB1), a cell type-specific nuclear matrix attachment region (MAR) DNA-binding protein, tethers to a specific DNA sequence and regulates gene expression through chromatin remodeling and HDAC (histone deacetylase complex) recruitment. In this study, a SATB1 eukaryotic expression plasmid was transfected into the human erythroleukemia K562 cell line and individual clones that stably over-expressed the SATB1 protein were isolated. Microarray analysis revealed that hundreds of genes were either up- or down-regulated in the SATB1 over-expressing K562 cell lines. One of these was the extra-cellular matrix glycoprotein, SPARC (human secreted protein acidic and rich in cysteine). siRNA knock-down of SATB1 also reduced SPARC expression, which was consistent with elevated SPARC levels in the SATB1 over-expressing cell line. Bioinformatics software Mat-inspector showed that a 17bp DNA sequence in the third intron of SPARC possessed a high potential for SATB1 binding; a finding confirmed by Chromatin immunoprecipitation (ChIP) with anti-SATB1 antibody. Our results show for the first time that forced-expression of SATB1 in K562 cells triggers SPARC up-regulation by binding to a 17bp DNA sequence in the third intron.

[Experiment study on biological and immunological characteristics of modified DNL of oral squamous cell carcinoma with TNF-alpha gene]

Growing characteristic of gene-transduced and nontransduced DNL in medium of containing rIL-2 was compared,and growing characteristic of gene-transduced DNL in medium of non containing rIL-2 was analyzed.DNA index (DI),cell cycle and immunologic phenotypes of gene-transduced and nontransduced DNL were analyzed with FACS.The results revealed interfered with growth,DL,cell cycle and immunologic phenotypes of DNL,and gene-transduced DNL couldn't growing infinitely.