[Analysis of 2 diagnostic criteria of echocardiography for coronary artery aneurysm in Kawasaki disease].

Objective: To analyze the difference between Z score and previous criteria in the diagnosis characteristics of coronary artery aneurysm (CAA) in Kawasaki disease, and to investigate the clinical distribution of Kawasaki disease CAA in the Z score group. Methods: This study retrospectively analyzed the clinical and echocardiographic data of 2 419 children with Kawasaki disease in Shenzhen Children's Hospital from January 2009 to December 2019. The traditional criteria and Z score criteria were used to diagnose CAA, and the differences of diagnostic efficiency between the 2 diagnostic methods were analyzed. The clinical distribution characteristics of CAA in children with Kawasaki disease were analyzed by grouping their sex, clinical classification (complete Kawasaki disease, incomplete Kawasaki disease) the sensitivity to intravenous immunoglobulin (IVIG) (IVIG-sensitive Kawasaki disease,IVIG-unresponsive Kawasaki disease). And the course of the disease (≤6 weeks, >6-8 weeks, >8 weeks to 6 months) etc. The χ² test or Kruskal-Wallis test was used for comparison between the groups, and the Kappa test was used for consistency evaluation. Results: Among the 2 419 children with Kawasaki disease, 1 558 were males and 861 were females. The age of onset was 1.8 (1.0, 3.2) years. The rate of CAA by Z score criteria was higher than that by traditional method (21.9% (529/2 419) vs. 13.9% (336/2 419), χ2=1 074.94, P<0.001). Compared to the traditional method, the Z score criteria found higher rate of CAA in male patients, patients with incomplete Kawasaki disease, and IVIG-unresponsive patients (25.2% (392/1 558) vs. 16.0% (249/1 558), (32.7% (166/507) vs. 19.5% (99/507), 30.5% (95/312) vs. 24.0% (75/312), χ2=694.05, 216.19, 184.37, all P<0.001). The Z score criteria was consistent with the traditional method in diagnosing CAA (κ=0.642,P<0.001). Moreover, in the Z score criteria, the rate of CAA in males (25.2%, 392/1 558) was higher than that in females (15.9%, 137/861), higher in incomplete Kawasaki cases (32.7%, 166/507) than that in complete Kawasaki case (19.0%, 363/1 912), and higher in IVIG-unresponsive cases (30.4%, 95/312) than that in IVIG-sensitive cases (20.6%, 434/2 107), with statistically significant differences (χ2=27.76, 44.38, 15.43, all P<0.001). Coronary Z score of course ≤ 6 weeks was greater than that of course between>6-8 weeks and >8 weeks to 6 months (1.3 (0.7, 2.3) vs. 0.7 (0.3, 1.4), 0.7 (0.3, 1.3), Z=20.65, 13.70, both P<0.001). Conclusions: The rate of CAA in Kawasaki disease by Z score criteria is higher than that by traditional method. In the Z score group, most CAA occur within 6 weeks of the course of the disease, and the rate of CAA in male, incomplete Kawasaki disease, and IVIG-unresponsive is higher.

[Analysis on diagnosis rate of chronic kidney disease in hospitalized pediatric patients].

Objective: To analyze diagnosis rate of chronic kidney disease (CKD) in hospitalized pediatric patients in a single center and understand pediatricians' awareness of CKD. Methods: This was a cross-sectional study. Children who were admitted to the Division of Pediatric Nephrology, Peking University First Hospital from January 1, 2008 to December 31, 2017 and met the diagnostic criteria of CKD (kidney disease: improving global outcomes 2012 guideline) were recruited. A total of 4 472 cases were enrolled. Original CKD diagnosis was collected from the home page of medical records. Actual CKD diagnosis was validated and corrected by reviewing medical records and recalculating glomerular filtration rate. The diagnosis rate and influencing factors of pediatric CKD, the distribution and etiology of actual CKD were analyzed. The comparison between groups were performed with χ(2) test. Results: In 4 472 cases, there were 3 470 cases in actual CKD stage 1, among which only 24 cases were in original CKD stage 1. There were 543 cases in actual CKD stage 2-3, among which only 181 cases were in original CKD stage 2-3. Three hundred and one cases were in actual CKD stage 4-5, including 290 cases in original CKD stage 4-5. In addition, there were 43 cases with unknown CKD stage and 115 cases with acute kidney injury. Compared to original CKD diagnosis, the diagnosis rates of CKD stage 1-5 were 0.7% (24/3 470), 16.7% (58/348), 63.1% (123/195), 90.7% (78/86) and 98.6% (212/215), respectively. The proportions of actual CKD stage 1-5 were 80.4% (3 470/4 314), 8.1% (348/4 314), 4.5% (195/4 314), 2.0% (86/4 314) and 5.0% (215/4 314). The etiology of actual CKD included primary glomerular disease (62.2%, 2 686/4 314), secondary glomerular disease (19.7%, 849/4 314), hereditary kidney disease (9.1%, 391/4 314), congenital abnormalities of the kidney and urinary tract (CAKUT) (3.1%, 135/4 314), tubulointerstitial disease (2.2%, 94/4 314) and etiology uncertain (2.1%, 89/4 314). The leading cause of end stage renal disease was etiology uncertain (31.1%, 67/215), followed by hereditary kidney disease (24.2%, 52/215), CAKUT (16.3%, 35/215) and primary glomerular disease (16.3%, 35/215). Conclusions: Among actual CKD hospitalized pediatric patients, the diagnosis rate of CKD given by physicians at discharge was relatively low, especially patients in earlier CKD stages, which reflected serious lack of physicians' awareness of CKD.

[Research Progress of CircRNA and Its Application Prospect in Forensic Medicine].

Circular RNA （circRNA） is a type of noncoding RNA with tissue specificity and high stability, which forms a closed continuous loop and is abundantly expressed in tissue cells. According to recent research, the regulatory function of circRNA elucidating in the occurrence and development of disease shows a potential for diagnosing clinical disease and revealing disease mechanism. This paper reviews the biological characteristics, analysis methods of circRNA and its research progress in clinical application as biomarker, and outlooks its application in the field of forensic medicine.

The AKT1/NF-kappaB/Notch1/PTEN axis has an important role in chemoresistance of gastric cancer cells.

The inherent resistance of tumors to DNA damage often limits the efficacy of chemotherapy. The aim of this work is to explore the potential mechanism for development of chemoresistance in gastric cancer. Our data revealed that AKT1 mRNA and protein expression were induced by doxorubicin (a chemotherapeutic agent); the doxorubicin-induced AKT1 expression and activation increased the binding of NF-kappaB on Notch1 DNA promoter and then promoted the Notch1 transcription and expression; enhanced expression of Notch1 further upregulated PTEN expression through CBF-1 binding to PTEN DNA promoter; and inhibition of AKT1 expression and activity sensitized the gastric cancer cell to doxorubicin treatment in cultured gastric cancer cell lines and xenograft nude mice gastric cancer model. Furthermore, our data demonstrated that both Notch1 and PTEN were absent or minimally expressed in gastric cancer tissue but abundant in paired normal gastric mucosa, and the expression of Notch1 correlated with that of PTEN. Together, these novel results suggested that a novel AKT1/NF-kappaB/Notch1/PTEN axis has an important role in the development of chemoresistance in gastric cancer. Notch1 has an anti-cancer role in gastric cancer.

[The state of cytoskeleton and its links "oxygen-peroxide" effects in some pathologies and apoptosis].

The cytoskeleton elements, especially the system of the microtubules, are responsible for production of cell backbone system, creation the global spatial ordered organization for efficient transport processes. Microtubules are involved into transportation of mitochondria, peroxisomes, microsomes, lyzosomes, Golgi apparatus, vesicular structures, some enzymes, adhesion molecules and, possibly, O2-depoting compounds. During disorganization of microtubules, mitochondria (principal consumers of intracellular O2), lose uninterrupted "address" delivery oxidizing substrates and O2. This may be one of important factors underlying mitochondrial dysfunctions accompanied by a rise and/or intensification of cells hyperoxia and oxidative stress. These impairments are obviously responsible for oxygen-peroxide effects in aging, age-related pathologies, carcinogenesis and apoptosis. The agents, both stabilizing and disorganizating microtubules appear to be apoptogenic for the tumors cells.

[Apoptosis and carcinogenesis in aging: oxygen-peroxide aspect].

New facts are given by the author for the general oxygen-peroxide concept of aging, cancerogenesis and apoptosis. The idea is confirmed that the cell breath dysfunction leads to the oxidative stress firstly in mitochondria, then in cytoplasm and in the cell in general is the starting moment for the induction of the named processes. The superfluous formation of the active oxygen forms, peroxides of lipids and proteins as signal molecules creates disbalance between pro- and antioxidants, which size increases in aging cells and even more in tumor's and apoptosis cells. In the limits of these specialized "disbalanses" the named signal molecules play key role not only on starting "mitochondrial" stages of aging process, carcinogenesis and apoptosis, but also on following "performing" stages. They influence on the work of performing links (telomerase, oncoproteins, transcription factors, proteinkinase, endonuclease, caspase and so on).

[The significance of pathological examination of the placenta in exploring the causes of intrauterine fetal death].

The results of pathological examination of 68 placental from intrauterine fetal death during 1982. 4-1989.12 is presented. The shortest time interval between the death of the fetus and the expulsion of the placenta was 14 hours, and the longest was 1 month. The pathological findings may be divided into 5 classes: trophoblastic; stromal; villous net; cord and others. Causes of fetal death could be identified in 65 cases (96%), in which 36 cases (53%) were due to the factors of placenta and its appendix. It was suggested that the pathological examination of placenta might give the clue to the cause of fetal demise.

[The combined magnetoradiotherapy of breast cancer]. / Kombinirovannaia magnitoluchevaia terapiia raka molochnoi zhelezy.

Preoperative magnetoradiation therapy of stage II-III breast cancer patients was followed by pronounced regression of tumor and axillary lymph node metastases in all cases. The treatment modality had been previously substantiated by establishing the optimal sequence and time intervals for magnetic and radiation fields. Complete regression of primary tumor and metastases verified by histologic and cytologic examination of surgical and biopsy material was observed in 20%. The best results were obtained for edematous-infiltrative form of cancer. In the control group (radiation alone), regression of tumor was only slight, nor did lymph node metastases regress. Magnetoradiation therapy did not involve either immediate or delayed adverse side-effects.

[Pathological analysis of 76 placentae in fetal distress].

The result of pathological analysis of 76 placentae and their appendices from clinically diagnosed fetal distress in year 1985-1989 is here presented. The findings could be classified into 4 groups; lesions due to disturbance of maternal blood flow and villous ischemia or hypoxia; retardation of development and malformation of villi; lesions due to haematogenous and ascending infection and pathological changes of the umbilical cord. The clinical significance of these pathological changes was discussed. We suggested that some lesions such as villous growth retardation, placental haemangioma, choriangiosis, infection of the placenta, single umbilical artery etc, could cause fetal distress, and villitis, single umbilical artery could sufficiently impair placental function so as to retard fetal growth or cause fetal malformation. The etiology of some placental lesions needs further study.

[Chemical studies on polysaccharide of Achyeanthes bidentata].

A peptide-polysaccharide, ABAB showing immunological activity was isolated from Achyeanthes bidentata Bl. It was shown to be homogeneous by HPLC and optical rotation analysis. Its molecular weight was estimated to be 2.3 x 10(4). It composed of D-glucuronic acid, D-galactose, D-galacturonic acid, L-arabinose and L-rhamnose in molar ratio of 12:2:3:1:1. Reduction of carboxyl groups, methylation analysis, periodate oxidation, Smith degradation and IR analysis showed that ABAB possesses a main chain composed of (1----4)-D-glucuronic acid and (1----4)-D-galacturonic acid residues. The non-reducing terminal residues in the side chains were L-arabinose and L-rhamnose. ABAB contained 24.1% of peptides composed of glycine, glutamic acid, aspartic acid and serine.

[Histomorphometry of the placenta in preeclampsia].

Ten term pregnancy placentas from preeclampsic cases, uncomplicated by essential hypertension, IUGR or renal disease were studied by means of histomorphometric analysis and the results were compared with 10 term pregnancy normal placentas. There was no significant statistical difference in the parameters between the two groups. In the membrane rolls and in a portion of placental bed biopsies from preeclampsic patients there was no acute atherosis in the spiral arteries. This study demonstrated that, the morphological and functional changes in the placentas of preeclampsia yielded little effect on fetal growth and that acute atherosis in spiral artery was not pathognomonic of preeclampsia.

Location of double bonds in fatty acids of fish oil and rat testis lipids. Gas chromatography-mass spectrometry of the oxazoline derivatives.

A new approach to the derivatization and analysis of long chain polyunsaturated fatty acids is described. The method is based on the formation of 2-alkenyl-4,4-dimethyloxazolines by condensation of the starting material with 2-amino-2-methylpropanol. The derivatization method is rapid, efficient and specific with respect to the chain feature of the parent acids. Volatility, comparable with that of the corresponding simple esters, and improved gas chromatographic separation are achieved without difficulty. The derivatives exhibit clear and regular fragmentation patterns that allow easy discrimination of positional isomers and assignment of double bond location in the chain.

Location of methyl branchings in fatty acids: fatty acids in uropygial secretion of Shanghai duck by GC-MS of 4,4-dimethyloxazoline derivatives.

2-Substituted 4,4-dimethyloxazolines (DMOX) have been found to be a useful alternative to the commonly used methyl esters for the localization of unsaturated bonds and other substituents in the fatty chain by mass spectrometry. The powerful directed fragmentation coupled with good gas chromatographic ability enables the structure elucidation of modified fatty acids in complex mixtures. Continuing our previous study, 76 out of a total of 86 fatty acids obtained from the preen gland wax of Shanghai duck now have been identified by gas chromatography-mass spectrometry (GC-MS) of their oxazoline derivatives. The identification was based on the interpretation of the mass spectra and comparison with the spectra and equivalent chain lengths (ECL) of the corresponding methyl esters. Main components of this lipid mixture are straight chain fatty acids (8.22%), and 2-, 4- or 6-monomethyl branched acids (53.69%), amounting to 61.91% of the total acid fraction. In addition, a large number of dimethyl-substituted fatty acids (31.4%) also have been found. Typical mass spectra, which are easily recognizable and highly specific for fatty acids substituted at various positions, are presented and classified according to the structural feature of the chain.

[Effect of antioxidants, pro-oxidants, respiration inhibitors and substrates on the formation of autonomic secondary colonies of Fusarium bulbigenum var. blasticola]. / Vliianie antioksidantov, prooksidantov, ingibitorov dykhaniia i substratov na formirovanie avtonomnykh vtorichnykh kolonii u Fusarium bulbigenum var. blasticola.

Autonomous secondary colonies are formed on the primary colonies of Fusarium bulbigenum var. blasticola grown in a synthetic Rieder medium. The secondary colonies are similar to genuine neoplasia in the following characteristics: dedifferentiation of the mycelium filamentous structure to yield single yeast-like cells, selective growth, faulty differentiation. Just as antioxidants and respiration substrates inhibit tumour formation and growth in higher organisms, they either prevent or inhibit the formation of secondary colonies in microorganisms. In contrast, their formation is stimulated when prooxidants and respiration inhibitors are added to the growth medium.