Predictive value of inflammatory markers on the risk of stroke-associated pneumonia in acute ischemic stroke patients / 临床神经病学杂志

Objective To explore the predictive value of inflammatory markers for stroke-associated pneumonia(SAP)in patients with acute ischemic stroke(AIS)based on the nomogram model.Methods According to whether pneumonia occurred,259 AIS patients were divided into SAP group(81 cases)and non-SAP group(178 cases).The clinical data of the two groups were compared.The systemic inflammatory response index(SIRI),systemic immunoinflammatory index(SII)and neutrophil to lymphocyte ratio(NLR)were calculated according to the formula.The variables with statistically significant differences were included in the multivariate binary Logistic regression model to screen out the independent risk factors for SAP in AIS patients.The independent risk factors were used to construct a predictive model,and the predictive ability of the two models,which only included traditional factors and included inflammatory indicators at the same time,was further compared from the aspects of discrimination,calibration,clinical practicability and so on.Reclassification analysis was used to evaluate the extent to which the nomogram model improved the predictive value of SAP risk in AIS patients.Results Compared with those in the non-SAP group,the rates of smoking,diabetes,dysphagia,leukocytes,neutrophils,lymphocytes,triglyceride level,NIHSS score on admission,SIRI,SII and NLR were significantly increased in the SAP group,and the rate of hypertension was decreased(all P＜0.05).Diabetes mellitus(OR =2.505,95%CI:1.070-5.850,P =0.034),dysphagia(OR =3.492,95%CI:1.501-8.119,P =0.004),NIHSS score on admission(OR = 1.310,95%CI:1.188-1.446,P＜0.001),SIRI(OR =2.417,95%CI:1.327-4.401,P =0.008),NLR(OR =1.434,95%CI:1.101-1.860,P =0.007)were independent risk factors for SAP in AIS patients.The area under the curve was 0.788(95%CI:0.725-0.852,P＜0.001)for the prediction model without inflammatory factors and 0.884(95%CI:0.838-0.930,P＜0.001)for the prediction model with independent risk factors.The calibration curve showed a good consistency between the predicted risk and the observed results.The decision curve showed that the model had a significant net benefit for predicting SAP.In addition,by calculating the net reclassification index(NRI)and the comprehensive discriminant improvement index(IDI),it was found that the nomogram model had a significant improvement in predicting the risk of SAP in AIS patients.Internal verification also proves the reliability of the nomogram model.Conclusions SIRI and NLR are independent predictors of SAP in AIS patients on admission.Adding SIRI and NLR to the traditional model can significantly improve the ability to identify the risk of SAP occurrence in AIS patients.

Identifying circRNA-associated-ceRNA networks in juvenile spondyloarthropathies patients.

BACKGROUND: Juvenile spondyloarthropathies (JSpA) are defined as a heterogeneous group of diseases that start before the age of 16. The study aimed to identify key genes and pathways that are influenced by circRNAs and to screen potential therapeutic agents for JSpA. The study involved the analysis of circRNA expression profiles, identification of circRNA-miRNA-mRNA regulatory networks, and functional annotation of differentially expressed genes. The results of the study may have provided insights into the molecular mechanisms underlying JSpA and potential therapeutic targets for this disease. METHODS: In this study, sequencing data of circRNA, miRNA, and mRNA were obtained from the GEO datasets. The data were then analyzed to identify candidates for constructing a circRNA-miRNA-mRNA network based on circRNA-miRNA interactions and miRNA-mRNA interactions. Functional enrichments of genes were performed using the DAVID database. A PPI network was constructed using the STRING database and visualized using Cytoscape software. The MCODE plugin app was used to explore hub genes in the PPI network. The expression changes in immune cells were assessed using the online CIBERSORT algorithm to obtain the proportion of various types of immune cells. Finally, the Connectivity Map L1000 platform was used to identify potential agents for JSpA treatment. Overall, this study aimed to provide a comprehensive understanding of the molecular mechanisms underlying JSpA and to identify potential therapeutic agents for this disease. RESULTS: A total of 225 differentially expressed circRNAs (DEcircRNAs), 23 differentially expressed miRNAs (DEmiRNAs) and 1324 differentially expressed mRNAs (DEmRNAs) were identified. We integrated 5 overlapped circRNAs, 7 miRNAs and 299 target mRNAs into a circRNA-miRNA-mRNA network. We next identified 10 hub genes based on the PPI network. KEGG pathway analysis revealed that the DEGs were mainly associated with JAK-STAT signal pathway. We found that neutrophils accounted for the majority of all enriched cells. In addition, we discovered several chemicals as potential treatment options for JSpA. CONCLUSIONS: Through this bioinformatics analysis, we suggest a regulatory role for circRNAs in the pathogenesis and treatment of JSpA from the view of a competitive endogenous RNA (ceRNA) network.

Inflammatory markers based on blood cell count predict functional outcomes in patients with acute ischemic stroke: construction and validation of a nomogram model / 国际脑血管病杂志

Objective:To investigate the value of inflammation markers based on blood cell count in the outcome assessment of acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the Department of Neurology, Taizhou People's Hospital from January 2022 to April 2023 were included retrospectively. The demographic and clinical data of the patients were collected, particularly the related inflammatory markers based on blood cell count, including systemic inflammation response index (SIRI) and neutrophil/lymphocyte ratio (NLR). The patients included in the study were randomly divided into a modeling cohort and a validation cohort according to 7∶3. In the modeling cohort, the outcome assessment was performed based on the modified Rankin Scale score at 90 d after onset, and the score >2 was defined as poor outcome. Multivariate binary logistic regression model was used to screen for independent influencing factors on the outcome of patients with AIS. All independent influencing factors were included to construct a nomogram prediction model, and validate its predictive ability in the validation cohort. Results:A total of 389 patients with AIS were included and randomly divided into a modeling cohort ( n=272) and a validation cohort ( n=117) in 7:3. There was no significant difference in demographic and clinical data between the modeling cohort and the validation cohort. In the modeling cohort, 196 patients were in the good outcome group and 76 were in the poor outcome group. Multivariate logistic regression analysis showed that the baseline National Institutes of Health Stroke Scale score (odds ratio [ OR] 1.31, 95% confidence interval [ CI] 1.18-1.45; P<0.001), SIRI ( OR 1.64, 95% CI 1.04-2.58; P=0.033), NLR ( OR 1.18, 95% CI 1.02-1.36; P=0.024), smoking ( OR 2.51, 95% CI 1.16-5.46; P=0.020) and diabetes ( OR 2.48, 95% CI 1.13-5.48; P=0.024) were the independent risk factors for poor outcomes of patients with AIS. The above independent risk factors were included for drawing a nomogram prediction model. The receiver operating characteristic curve analysis showed that the area under the curve of the prediction model was 0.866 (95% CI 0.816-0.917), indicating that the model had good discrimination. The validation conducted in the validation cohort showed that the area under the curve of the prediction model was 0.884 (95% CI 0.804-0.964). The calibration curve and decision curve analysis also proved the reliability of the prediction model. Conclusions:SIRI and NLR are associated with poor outcomes of patients with AIS. The inclusion of SIRI and NLR in the nomogram model can accurately predict the risk of poor outcomes in patients with AIS.

Treatment of NLRP3 gene mutation associated autoimmune diseases with kanamycin: a report of 4 cases with literature review / 中华风湿病学杂志

Objective:Four cases with NLRP3-related autoinflammatory diseases were reported to summarize the clinical characteristics, genotype, and treatment responses of the disease, and to improve clinical pediatricians' understanding of the disease.Methods:A retrospective analysis was performed on 4 cases with NLRP3-related autoinflammatory diseases diagnosed in Children's Hospital of Anhui Province in 2016—2021, and the clinical features and treatment progress of NLRP3-related autoinflammatory diseases were retrospectively analyzed based on the clinical features, gene reports, and literature review.Results:① All 4 cases were male. Cases 1, 2, and 3 had the disease onset after birth, and case 4 had the disease onset 6 months after birth. All showed periodic fever, repeated urticaria-like rash, protruding forehead, and saddle nose. White blood cells count, erythrocyte sedimentation rate, and C-reactive protein were increased during the attack period, and those in the interval period were normal, and antibiotic treatment was ineffective. ② The genetic test of all these 4 children showed NLRP3 mutation. Children 1, 2, and 3 were heterozygous mutations, and their parents were wild-type. The mutation was located at chromosome Chr1: 247587658, exon c913 (exon3). G>A, the 305th aspartic acid (Asp) of the protein was changed to asparagine (Asn) in child 1. The mutation was located at the chromosomal Chr1: 247588072, the nucleic acid was changed to c1327(exon3)T>C, and the amino acid was changed to p.Y443H in cases 2 and 3. Somatic heterozygous mutation was found in case 4, and the child's parents were wild-type. In this case, the mutation was located at chromosomal Chr1: 247587658, exon3 G>A, and the 305th Asp of the protein was changed to Asn. ③Children in cases 1, 2, and 3 were treated with glucocorticoids and non-steroidal anti-inflammatory drugs at the initial stage, but the effects were limited. After receiving IL-1 antagonist treatment fever, skin rash, joint swelling and pain disappeared, and the inflammatory indexes were returned to normal. The child 4 received non-steroidal anti-inflammatory drugs and methotrexate, but he failed to respond to the treatment. Treatment with tocilizumab was not effective, however, fever, skin rash, or joint pain disappeared after treated with Khanna.Conclusion:①NLRP3-related autoinflammatory diseases can cause periodic fever, urticaria, joint involvement, and severe involvement of the central nervous system and organ amyloidosis. Which are early misdiagnosis is prone to systemic juvenile idiopathic arthritis. ②The disease was an inflammatory disease mediated by interleukin-1. At present, non-steroidal anti-inflammatory drug, glucocorticoid and chronic anti-rheumatic drugs have limited effects. IL-1 antagonists are effective and safe in the treatment of the disease.

Application of training methods of clinical skills competition for college students in standardized training of anesthesiologists / 中华医学教育探索杂志

This study summarizes the skills training work of the National College Students' Clinical Skills Competition for 9 consecutive years, and explores a set of teaching methods suitable for the standardized training of residents of anesthesiology. This method is applied to the clinical operation, professional theory, clinical thinking, humanistic care, doctor-patient communication and other aspects of the standardized training of residents. The results show that the teaching effect of all aspects of standardized training of residents is more practical and efficient, and residents can quickly master the basic operation skills of anesthesia in a short time, indicating that the training method of clinical skills competition of college students can be applied in the standardized training of anesthesia residents, which can effectively improve the training effect.

Spectrum change of rheumatic diseases in hospitalized children: a 12-year single-center experience of Shanghai / 中华风湿病学杂志

Objective:To gain insight into the constitution of juvenile rheumatic diseases, treatment outcome and trends of rheumatic inpatients in past 12 years, and to improve awareness of juvenile rheumatic diseases.Methods:The clinical data of 5 950 patients in rheumatology department of the affiliated pediatric hospital of Fudan University (from 2005 to 2016) were analyzed retrospectively, and the chi-square test was used to compare and analyze the incidence.Results:Disease changes: ① The top three rheumatic diseases were Kawasaki disease (KD) (44.3%), Henoch-schoniein purpura (HSP) (35.4%), juvenile idiopathic arthritis (JIA)(9.6%). ② The number of all constitution of juvenile rheumatic diseases in hospital increased other than HSP. ③ The rheumatic diseases were increased from 17 to 37 kinds in the past 6 years. ④ The number of systemic lupus erythematosus (SLE) increased year by year (112/2 348 vs 197/3 602, χ2=1.41, P=0.235), as well as the severe SLE (35/112 vs 55/197, χ2=0.38, P=0.536). ⑤ The rate of rheumatic diseases complicated with macrophage activation (MAS) was 7.2‰(43/5 950). 12.9%(26/201) of systemic juvenile idiopathic arthritis(sJIA) were complicated with MAS, which was accounted for 60.5%(26/43) of total number of MAS in rheumatic diseases. In the last 6 years, there was a significant increase in the number of patients with MAS in patients with rheumatic diseases ( χ2=14.1, P<0.01) and sJIA( χ2=11.2, P<0.01). ⑥ 1.1%(64/5 950) of rheumatic diseases patients had lung lesions, juvenile dermatomyositis (JDM) accounted for 24.4%(20/82). In the last 6 years, the number of patients with lung lesions associated with rheumatic diseases increased significantly ( χ2=5.66, P=0.017). ⑦ The mortality rate of juvenile rheumatic diseases was only 3.7‰(22/5 950), and 45.5% occurred in SLE (10/22). The mortality rate of SLE decreased in last 6 years (5/112 vs 5/197, χ2=0.34, P=0.558). Conclusion:The constitution of juvenile rheumatic diseases in our center is decreasing for systemic vasculitis (KD, HSP), JIA, SLE, JDM in last 6 years. The annual total number of patients is relatively stable. But rare, difficult and critically illed cases increase year by year. Although SLE is still the primary cause of death in juvenile rheumatic diseases in recent 6 years, the mortality rate has decreased year by year.

Effect of Trendelenburg position and artificial pneumoperitoneum on change of respiratory mechanics in-dexes due to change of preset airway pressure in PCV / 实用医学杂志

Objective In pressure controlled ventilation(PCV),a self-control method was used to ob-serve the change of respiration mechanics indexes under Trendelenburg position and pneumoperitoneum versus su-pine position and non-pneumoperitoneum with preset airway pressure.Methods Thirty patients scheduled for lapa-roscopic radical resection of rectal carcinoma were enrolled in this study.ECG,MAP,SpO2,BIS and body temper-ature were routinely detected. After induction of anesthesia,volume controlled ventilation(VCV)was used as ba-sic ventilation,and then switched to PCV after 5 minutes. The airway pressure was the preset airway pressure be-fore pneumoperitoneum,then was lowered 1 cmH2O in proper order,and then restored preset airway pressure and increased 1 cmH2O. 15 minutes after pneumoperitoneum,the airway pressure of PCV was used as preset airway pressure after pneumoperitoneum,and then the above procedure was repeated.The time interval was at least 5 min-utes.The values of MAP,HR,SpO2,VT and Cdyn were recorded at each time;VT,and Cdyn were continuously recorded five times to take the average value. The postoperative recovery in patients was observed. Results After pneumoperitoneum,the values of Cdyn and VT were significantly reduced(P < 0.01),MAP was increased(P <0.05). When the preset airway pressure changed 1 cmH2O,ΔVT was decreased(P < 0.05),and the change of Cdyn was not statistically significant. Conclusions As altering a unit of the preset airway pressure in PCV,the change in VT is significantly reduced but Cdyn does not change markedly in Trendelenburg posture and artificial pneumoperitoneum,as compared with supine position and non-pneumoperitoneum.

Coenzyme Q10 treatment for one child with COQ6 gene mutation induced nephrotic syndrome and literature review / 中华儿科杂志

Objective@#To summarize the clinical manifestation and molecular characteristics of COQ6 mutation induced nephrotic syndrome, and to evaluate efficacy of CoQ10 therapy.@*Method@#Clinical data of the case with infantile nephrotic syndrome was summarized, including clinical manifestations, laboratory findings and family investigation. The patient received CoQ10 30 mg/(kg·d) therapy. Urine protein/creatinine ratio, serum albumin and creatinine were detected to assess the efficacy of the therapy.@*Result@#(1) The 10 months old boy was presented with nephrotic level proteinuria and hypoalbuminemia. Extra-renal manifestations included cardiovascular abnormality, motor and mental retardation and unilateral ptosis. The patient had no consanguinity. A novel homozygous p. R360W mutation in COQ6 gene was identified and confirmed by next-generation sequencing and Sanger sequencing, respectively. Family analysis showed that homozygous p. R360W mutation in COQ6 gene was inherited from his parents. Missense p. R360W mutation was damaging by prediction online PolyPhen and SIFT software. After 2 months of CoQ10 complementary therapy, the patient′s urine protein/creatinine ratio declined from 7.2 to 1.3, and decreased further to 0.01 mg/mg with normal albumin level and renal function within 3 months. Nephropathy remission was maintained and growth retardation improved significantly during the last follow-up. Nevertheless, the patient manifested with sensorineural deafness at the age of 2 years. (2) There were 6 different mutations in coenzyme Q10 biosynthesis monooxygenase 6 (COQ6) in 13 individuals from 7 families by homozygosity mapping in the whole world. Each mutation was linked to early-onset SRNS with sensorineural deafness. Renal biopsy revealed FSGS in 7 cases and DMS in 1 case. Other manifestations included ataxia, seizures, facial dysmorphism, nephrolithiasis and growth retardation. Four patients received CoQ10 supplementation and responded to the treatment.@*Conclusion@#Renal disease caused by recessive COQ6 gene mutation was nephrotic syndrome. The patient benefited from early CoQ10 complement and reached nephropathy remission.

Clinical and genetic characters of 8 Chinese children with ADCK4-associated glomerulopathy / 中华肾脏病杂志

Objective@#To investigate the clinical and genetic character of Chinese children with the aarF domain containing kinase 4 (ADCK4)-associated glomerulopathy.@*Methods@#Applying next generation sequencing to detect possible gene mutation(renal disease associated monogene was pooled as one panel) in 69 children with steroid-resistant nephrotic syndrome (SRNS) or persistent proteinuria of unknown origin. Sanger sequencing was used to confirm the significant mutations found in the children and to validate these mutation sites in their patients. Using online software (PolyPhen2, SIFT, Mutation Taster) to predict whether the detected missense mutations were disease causing or not. Collecting and analyzing clinical data of children with ADCK4-associated glomerulopathy, which included onset age, clinical manifestation, and renal pathology.@*Results@#The ADCK4 gene mutation was detected in 8 children with a positive rate of 11.6% (8 out of 69), among which 3 patients carried homozygous c.748G>C mutation, 3 patients carried homologous c.737G>A mutation, 1 patient carried compound heterozygous mutation(c.748G>C and c.737G>A), and 1 patient carried compound heterologous mutation(c.551A>G and c.737G>A). Collectively, there were only 3 mutation sites found in total 8 patients, in which the mutation sites of c.748G>C and c.737G>A had high detection frequency in these 8 patients. These 3 mutation sites were all missense mutation which were predicted to be disease causing by online software and not reported before. The average onset age was 6.5 years (2 years-11.75 years). Four patients presented with SRNS and the other 4 presented with persistent proteinuria. All 8 patients had no extrarenal manifestation, renal biopsy revealed focal segmental glomerulosclerosis (FSGS) in most patients, among which 3 cases had gone to end-stage renal disease (ESRD) at disease onset, and 2 cases progressed to ESRD 2 and 5 years after onset respectively. Seven patients had received glucocorticoid and/or immunosuppressive drug while only one patient getting partial response. All 8 patients were treated with large amount of coenzyme Q10 (15 mg·kg-1·d-1) after definite diagnosis of ADCK4 mutation-some patients had acquired encouraging curative effect.@*Conclusions@#ADCK4-associated glomerulopathy is not rare especially in the children with SRNS. The onset age is relatively old and the extrarenal manifestation is less common. FSGS is a main pathology type. Patients usually have no response to immunosuppressive therapy, but may benefit from addition of large amount of coenzyme Q10. Some patients may only manifest with insidious proteinuria, causing the early diagnosis to be difficult, which deserves more attention. Three new missense mutations expand disease causing mutation repertoire of ADCK4 gene, among which the two sites of c.748G>C and c.737G>A may be mutation hotspot of ADCK4-associated glomerulopathy in Chinese population, and need further study.

Angiopoietin-like protein 3 induces podocytes actin rearrangement via integrin beta 3 / 中华肾脏病杂志

Objective@#To explore whether Angiopoietin-like protein 3 (ANGPTL3) is involved in podocyte actin rearrangement, and to analyze whether integrin β3 signal pathway is a key in ANGPTL3 inducing actin rearrangement.@*Methods@#The cultured podocytes were divided into six groups: wild type, ADR treated, ADR+Dex, MOCK, ANGPTL3-cDNA, miRNA, and AD+miRNA group. (1) We observed actin cytoskeleton using Invitrogen reagents with confocal microscopy; (2) Actin cytoskeleton after blocking β3 on podocytes was; (3) The expression of total FAK and p-FAK was through Western blotting.@*Results@#(1) The wild type podocyte's cytoskeleton is arranged orderly. After ADR treatment, podocyte's actin are rearranged and weaken (P<0.05). There was no significant difference in actin arrangement between knock-down and MOCK group. In ANGPTL3-cDNA group the podocyte actin was also significantly rearranged; on the contrary, in miRNA+ADR group, the actin rearrangement never obviously happened (P<0.05). (2) Over-expression of ANGPTL3 podocytes blocked integrin β3 did not happen actin rearrangement. (3) The expression of p-FAK significantly increased in over-expression ANGPTL3 podocytes.@*Conclusion@#ANGPTL3 is a key in inducing actin rearrangement. Intergrin β3 maybe a central pathway in ANGPTL3's role with podocytes.

Long term effect of tocilizumab on refractory systemic juvenile idiopathic arthritis / 临床儿科杂志

Objective To summarize the treatment experience of refractory systemic juvenile idiopathic arthritis (JIA) by tocilizumab, and to explore the cost-effective treatment. Methods The clinical data of 6 pediatric patients with refractory systemic JIA treated by tocilizumab from 2014 to June 2016 were retrospectively analyzed in the aspects of course and effectiveness of tocilizumab, steroid reduction, adverse reaction, and growth. Results The median age of the six patients (3 males and 3 females) was 6 years, and the course of disease were from 16 to 63 months. All patients were treated by other immunosuppressive agents or biological agents in addition to steroid and traditional anti-rheumatic drug therapy. The courses of tocilizumab treatment were from 7 to 26 months and the median time was 9.5 months. All 6 patients responded to tocilizumab and achieved the clinical remission at different time. After the induced remission, the interval of the treatment intervention was increased from 2 weeks up to 4 weeks in 3 cases, and no disease activity was observed. Except one case, another 5 cases reduced and stopped the use of hormones at 5.8 months after tocilizumab treatment. After hormones was reduced and discontinued, the growth was improved. All 6 patients had no serious adverse reactions. Conclusions Tocilizumab is safe and effective for patients with refractory JIAs. The steroid can be reduced in short time to improve growth. After remission is induced, the interval of the treatment intervention could be prolonged.

Angiopoietin-like protein 3 induces podocytes actin rearrangement via integrin beta 3 / 中华肾脏病杂志

Objective To explore whether Angiopoietin-like protein 3 (ANGPTL3) is involved in podocyte actin rearrangement,and to analyze whether integrin β3 signal pathway is a key in ANGPTL3 inducing actin rearrangement.Methods The cultured podocytes were divided into six groups:wild type,ADR treated,ADR+ Dex,MOCK,ANGPTL3-cDNA,miRNA,and AD +miRNA group.(1) We observed actin cytoskeleton using Invitrogen reagents with confocal microscopy;(2) Actin cytoskeleton after blocking β3 on podocytes was;(3) The expression of total FAK and p-FAK was through Western blotting.Results (1) The wild type podocyte's cytoskeleton is arranged orderly.After ADR treatment,podocyte's actin are rearranged and weaken (P ＜ 0.05).There was no significant difference in actin arrangement between knock-down and MOCK group.In ANGPTL3-cDNA group the podocyte actin was also significantly rearranged;on the contrary,in miRNA +ADR group,the actin rearrangement never obviously happened (P ＜ 0.05).(2) Over-expression of ANGPTL3 podocytes blocked integrin β3 did not happen actin rearrangement.(3) The expression of p-FAK significantly increased in over-expression ANGPTL3 podocytes.Conclusion ANGPTL3 is a key in inducing actin rearrangement.Intergrin β3 maybe a central pathway in ANGPTL3's role with podocytes.

Etiological analysis of 264 cases with chronic kidney disease stage 2 to 5 in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To study and summarize the etiology of children patients with chronic kidney disease (CKD) stage 2 to 5 seen in Children's Hospital of Fudan University from Jan. 2004 to Dec. 2013.</p><p><b>METHOD</b>By complying with the NKF-K/DOQI guidelines, we collected data of 264 cases of children patients with CKD stage 2-5 from Jan. 2004 to Dec. 2013 in the medical record system of Children's Hospital of Fudan University. And we retrospectively analyzed their age and CKD stage at first diagnosis, primary diseases, complications, etc.</p><p><b>RESULT</b>In the collected 264 cases, 52 cases (19.7%) were diagnosed at stage 2, 67 (25.4%) at stage 3, 52 (19.7%) at stage 4 and 93 (35.2%) at stage 5. For disease causes, 116 cases (43.9%) had congenital anomalies of the kidney and urinary tract (CAKUT), 61 cases (23.1%) had glomerular disease, 15 (5.7%) had hereditary kidney disease, 14 (5.3%) had other diseases and in 58 cases (22.0%) the causes of disease were unknown. In the group with age between 0 and 3.0 and 3.1 and 6.0 years, 57.1% (24 cases) and 60.0% (30 cases) had primary disease with CAKUT. In the group with age older than 10 years, 49.2% (30 cases) had primary disease with glomerular disease and 32.0% (32 cases) with unknown causes.</p><p><b>CONCLUSION</b>The major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT (43.9%), followed by glomerular disease (23.1%). The primary diseases of CKD were significantly different between the 2 age groups. CAKUT was more common in infants and preschool children while for adolescents, glomerular disease was the major cause.</p>

Resveratrol regulates iNOS to inhibit atherosclerosis in C57BL/6J mice / 中国病理生理杂志

AIM:To investigate the effect of resveratrol on the lipids ( CHOL, TG, LDL-C and HDL-C) , ni-tric oxide ( NO) , peroxynitrite anion ( ONOO-) and the expression of inducible nitric oxide synthase ( iNOS) in the artery of the mice with ovariotomy ( OVX) .METHODS:The lipid levels and NO level in the serum were measured .The chan-ges of atherosclerosis were evaluated with Oil Red O staining .The expression of iNOS was measured by DAB staining and Western blot .The ONOO-production was measured by DAB staining .RESULTS:Compared with sham group , the levels of the lipids and NO production in OVX +high fat (HF) group were increased (P<0.05).Compared with OVX+HF group, the levels of the lipids and NO production in resveratrol group were decreased (P<0.05).Fourteen weeks later, the atherosclerosis model was successfully established .Compared with OVX +HF group, the iNOS expression and the ONOO-production in resveratrol group were decreased ( P<0.05 ) , while those in sham group were increased ( P <0.05).CONCLUSION:Resveratrol prevents and treats atherosclerosis by inhibiting the iNOS expression in C 57BL/6J mice.

Application of Spiral CT in Orthodontic Micro-implant Anchorage Implantation Diagnosis / 昆明医科大学学报

Objective To evaluate the results of orthodontic micro- implant anchorage implantation by application of Spiral CT and three-dimensional reconstruction techniques,so as to explore its application value in assisting clinical diagnosis and treatment. Methods 20 orthodontic patients were implanted with 48 micro-planting screws. SOMATOM Sensation40/64 helical CT scan was performed . The axial unenhanced helical CT data were given multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering (VR) and surface multidimensional reconstruction (CPR) by using the Siemens 3D post-processing software. The axial scanning images and reconstructed images were compared, observed and analyzed . Results The planting results of 37 micro screws were satisfactory without injuring the vital tissues surrounding the root. The planting results of 11 micro-screw were not ideal, and these micro-screws were observed or reimplanted and got success. Spiral CT axial scan showed better the tooth root interval and the relationship between tooth root and the planting screws. VR can directly showed the overall relationship between the planting screws and teeth , jaw contour appearance. The relationship between the screw and tooth was showed satisfactorily by MIP which could rotate freely and observe from different angles. MPR could clearly show the structural relationships between micro-root planting screws and tooth root and surrounding tissues from the cross section, and could make up for the shortcomings of axial limitations, and was easy to measure the distance and tilt angle of the long axis . Conclusion Spiral CT and three-dimensional reconstruction can accurately show the jaw micro planting screw shape,location and spatial relationships with adjacent teeth , the image is clear,intuitive and definite,and spiral CT and three-dimensional reconstruction has high application value in orthodontics micro-implant anchorage clinic as a powerful auxiliary examination means.

Effects of dexmedetomidine on hemodynamics in hypertensive patients undergoing thyroid surgery with local anesthesia / 中国医师杂志

Objective To explore the effect of dexmedetomidine on hemodynamics in hypertensive patients undergoing thyroid surgery with local anesthesia.Methods Sixty patients with preoperatively diagnosed class Ⅰ to Ⅱ hypertension undergoing selective thyroidectomy were randomly divided into D (dexmedetomidine) and M (midazolam) groups (30 patients in each group).Doses of dexmedetomidine 0.5 μg/kg were finished in 20 minutes injection in patients of D group before the start of the surgery,then sequentially maintained at the rate of 0.1 ～ 0.5 μg/ (kg · h) with decreasing speed of 0.1 μg/(kg · h) when systolic pressure kept down to 110 mmHg or heart rare down to 60 bpm or Ramsay score of 3 points.The patients in M group were injected with midazolam 0.04 mg/kg 20 minutes before the start of surgery,then maintained at the rate of 0.02 ～ 0.05 mg/(kg · h),decreasing speed of 0.1 mg/(kg · h) to keep Ramsay score of 3 points if necessary.Two groups of patients with Ramsay score of 3 points but a high blood pressure (higher than 30％ of basic level) or heart rate (more than 100 bpm) were treated with drugs during operation.Record the systolic pressure,diastolic pressure,heart rate and Ramsay score at the time of before medication (T0),the injection of local anesthetics (T1),the start of surgery (T2),pain compliments required additional local anesthetics (T3),dealing with gland (T4) and the end of surgery,VAS in 8 h after operation and adverse reaction were recorded.Results In D group,the dosages of urapidil and esmolol [(10 ±5)mg and (0 ±0)mg] were significantly less than those in patients of M group [(60 ± 10) mg and (80 ±5) mg,t =14.82,t =19.78,P ＜ 0.05].Blood pressure and heart rate were all significantly decreased at the time of T1,T2 and T5 when comparing with T0(P ＜0.05 orP ＜0.01),and only heart rate was significantly decreased at the time of T3 and T4 (P ＜ 0.05).While in M group,blood pressure and heart rate were higher than basic levels at the time of T3 and T4 (P ＜ 0.05).Besides,lower blood pressure and heart rate were less than those in M group at all observed time expect T0 (P ＜ 0.05).Conclusions Good sedation effects can be produced by both dexmedetomidine and midazolam in hypertensive patients undergoing thyroid surgery with local anesthesia,but dexmedetomidine was determined more suitable in sedation and anti-hypertension in patients with light to moderate hypertension for better hemodynamic stability effect with local anesthesia.

Molecular mechanism of dexamethasone affecting podocyte motility / 中华肾脏病杂志

Objective To investigate the potential roles of dexamethasone (Dex) in podocyte motility,and to explore the mechanism of modulating α-actinin-4,nephrin.Methods Podocytes were divided into three groups:Dex group [1 μmol/L Dex +50 mg/L puromycin aminonucleoside (PAN)],PAN group (50 mg/L) and normal control group.Scrape wound assay and Transwell migration assay were used to detect cell motility.Filtering ratio of podocytes was measured by FITC labeled BSA.Real-time PCR and Western blotting were used to examine the expressions of c-actinin-4 and nephrin.Results From the scrape wound assays,the ability of wound repair in podocytes of PAN group was significantly increased (P＜0.01),and the number of migrating cells in this group also rose (P＜0.01).Compared to PAN group,podocytes in Dex group did not enhance the motility after treatment with the same dose PAN (P＜0.01).Real-time PCR and Western blotting showed that Dex could significantly inhibit the up-regulated expression of α-actinin-4 and nephrin induced by PAN.Conclusions Dex can relieve the enhanced motility induced by PAN.Its mechanism may be associated with the modulation of the expressions of α-actinin-4 and nephrin.

Testosterone induces cardiomyocyte hypertrophy in rats and upregulates the expression of ERK1/2 / 基础医学与临床

Objective To explore the role of ERK1/2 protein in development of myocardial hypertrophy.Methods Myocardial cells were isolated from ventricles of 1～3-day-old neonate rats and purifed by a culture method.Neonate rat cardiomyocyte hypertrophic responses were assayed by measuring protein content,protein synthesis rate and cell surface area.Expression of protein ERK1/2 were detected by Western blot.Results Cell protein content,~3H-leucine(~3 H-Leu)incorporation and cell surface area increased by treating of cardiomyocytes with T(10~(-10)～10~(-6) mol/L)for 24 h.The maxium effect was observed at the concentration of 10~(-8) mol/L.The increase of cell protein content induced by T was inhibited by pretreating with flutamide(10~(-5) mol/L)for 2 h,while there was no effect on cardiomyocytes pretreating with flutamide alone.The increase of ~3H-Leu incorporation induced by T was blocked by PD98059(50 μmol/L).Expression of ERK1/2 was upregulated significantly by treating with testoster one for 24 h at the level of 10~(-8) mol/L.The increased expression of ERK1/2 induced by T was reversed by pretreating with flutamide(10~(-5) mol/L)for 2 h.Conclusion T with physio-concentration may induce cardiomyocyte hypertrophy and this effect was possibly mediated through the activation of ERK1/2 signalling.During this procession,T upregulated the protein expression of ERK1/2 mediated by androgen receptor.

Effect of caveolin -1 and ERK1/2 on 17β-estradiol -induced inhibition of VSMC proliferation / 中国病理生理杂志

AIM: To investigate the effect of caveolin - 1 and phosphorylation of ERK1/2 on 17β - estradiol ( E_2 ) induced inhibition of vascular smooth muscle cells ( VSMCs ). METHODS: The proliferation in cultured VSMCs was determined by using [~3H ] - thymidine incorporation. The expressions of caveolin - 1, MKP -1 and ERK1/2 phosphorylation were measured by Western blotting. The expression of caveolin - 1 mRNA was measured by RT - PCR. RESULTS: Exposed to fetal calf serum ( FCS) for 24 h, the increase in proliferation of VSMCs was detected by [~3H] -thymidine incorporation. Pretreatment with various concentrations of E_2 for 24 h inhibited VSMC proliferation induced by FCS. The results of Western blotting and RT - PCR showed that pretreated with 17β - estradiol for 24 h reserved the decrease in caveolin - 1 induced by FCS. Western blotting results further proved that the expression of MKP - 1 was significantly increased and the expression of ERK1/2 phosphorylation was decreased after incubated with 17β - estradiol. CONCLUSION: 17β -estradiol increases caveolin - 1 and MKP - 1 expressions, and decreases ERK1/2 phosphorylation, leading to the inhibition of VSMC proliferation.

Effect of caveolin-1 and ERK1/2 on 17?-estradiol-induced inhibition of VSMC proliferation / 中国病理生理杂志

AIM:To investigate the effect of caveolin-1 and phosphorylation of ERK1/2 on 17?-estradiol (E2) induced inhibition of vascular smooth muscle cells (VSMCs). METHODS:The proliferation in cultured VSMCs was determined by using [3H]-thymidine incorporation. The expressions of caveolin-1,MKP-1 and ERK1/2 phosphorylation were measured by Western blotting. The expression of caveolin-1 mRNA was measured by RT-PCR. RESULTS:Exposed to fetal calf serum (FCS) for 24 h,the increase in proliferation of VSMCs was detected by [3H]-thymidine incorporation. Pretreatment with various concentrations of E2 for 24 h inhibited VSMC proliferation induced by FCS. The results of Western blotting and RT-PCR showed that pretreated with 17?-estradiol for 24 h reserved the decrease in caveolin-1 induced by FCS. Western blotting results further proved that the expression of MKP-1 was significantly increased and the expression of ERK1/2 phosphorylation was decreased after incubated with 17?-estradiol. CONCLUSION:17?-estradiol increases caveolin-1 and MKP-1 expressions,and decreases ERK1/2 phosphorylation,leading to the inhibition of VSMC proliferation.