FOXO1 reshapes neutrophils to aggravate acute brain damage and promote late depression after traumatic brain injury.

BACKGROUND: Neutrophils are traditionally viewed as first responders but have a short onset of action in response to traumatic brain injury (TBI). However, the heterogeneity, multifunctionality, and time-dependent modulation of brain damage and outcome mediated by neutrophils after TBI remain poorly understood. METHODS: Using the combined single-cell transcriptomics, metabolomics, and proteomics analysis from TBI patients and the TBI mouse model, we investigate a novel neutrophil phenotype and its associated effects on TBI outcome by neurological deficit scoring and behavioral tests. We also characterized the underlying mechanisms both in vitro and in vivo through molecular simulations, signaling detections, gene expression regulation assessments [including dual-luciferase reporter and chromatin immunoprecipitation (ChIP) assays], primary cultures or co-cultures of neutrophils and oligodendrocytes, intracellular iron, and lipid hydroperoxide concentration measurements, as well as forkhead box protein O1 (FOXO1) conditional knockout mice. RESULTS: We identified that high expression of the FOXO1 protein was induced in neutrophils after TBI both in TBI patients and the TBI mouse model. Infiltration of these FOXO1high neutrophils in the brain was detected not only in the acute phase but also in the chronic phase post-TBI, aggravating acute brain inflammatory damage and promoting late TBI-induced depression. In the acute stage, FOXO1 upregulated cytoplasmic Versican (VCAN) to interact with the apoptosis regulator B-cell lymphoma-2 (BCL-2)-associated X protein (BAX), suppressing the mitochondrial translocation of BAX, which mediated the antiapoptotic effect companied with enhancing interleukin-6 (IL-6) production of FOXO1high neutrophils. In the chronic stage, the "FOXO1-transferrin receptor (TFRC)" mechanism contributes to FOXO1high neutrophil ferroptosis, disturbing the iron homeostasis of oligodendrocytes and inducing a reduction in myelin basic protein, which contributes to the progression of late depression after TBI. CONCLUSIONS: FOXO1high neutrophils represent a novel neutrophil phenotype that emerges in response to acute and chronic TBI, which provides insight into the heterogeneity, reprogramming activity, and versatility of neutrophils in TBI.

Baicalin ameliorates multidrug-resistant Pseudomonas aeruginosa induced pulmonary inflammation in rat via arginine biosynthesis.

Multidrug-resistance (MDR) Pseudomonas aeruginosa (P. aeruginosa) is a lethal gram-negative pathogen causing hospital-acquired and ventilator-associated pneumonia, which is difficult to treat. Our previous studies confirmed that baicalin, an essential bioactive component in Scutellaria baicalensis Georgi, exhibited anti-inflammatory effects in an acute pneumonia rat model induced by MDR P. aeruginosa. However, this effect of baicalin in constrast its low bioavailability, and its mechanism of action is still unknown. Thus, this study investigated whether the therapeutic effects of baicalin against MDR P. aeruginosa acute pneumonia are owing to the regulation of gut microbiota and their metabolites using pyrosequencing of the 16S rRNA genes in rat feces and metabolomics. As a result, baicalin attenuated the inflammation by acting directly on neutrophils and regulated the production of the inflammatory cytokines TNF-α, IL-1ß, IL-6, and IL-10. The mechanisms were through down-regulation of TLR4 and inhibition of NF-κB. Furthermore, pyrosequencing of the 16S rRNA genes in rat feces revealed that baicalin regulated the composition of gut microbial communities. At the genus level, baicalin efficiently increased the abundance of Ligilactobacillus, Lactobacillus and Bacteroides, but decreased the abundance of Muribaculaceae and Alistipes. Further, arginine biosynthesis was analyzed as the core pathway regulated by baicalin via combination with predicting gut microbiota function and targeted metabolomics. In conclusion, this study has demonstrated that baicalin relieved inflammatory injury in acute pneumonia rat induced by MDR P. aeruginosa via arginine biosynthesis associated with gut microbiota. Baicalin could be a promising and effective adjunctive therapy for lung inflammation caused by MDR P. aeruginosa infection.

Research trends of acupuncture therapy for hypertension over the past two decades: a bibliometric analysis.

Acupuncture has already been extensively utilized to treat high blood pressure (hypertension) in several nations. Nevertheless, the bibliometric research on the worldwide usage of acupuncture for hypertension is mostly unclear. As a result, our objective for the research aimed to investigate the present state as well as developments in the global usage of acupuncture on hypertension during the last 20 years using CiteSpace (5.8.R2). The Web of Science (WOS) database examined papers on acupuncture treatment of hypertension from 2002 to 2021. We examined the number of publications, cited journals, nations/regions, organizations, authors, cited authors, cited references, and keywords utilizing CiteSpace. The record of 296 documents was obtained between 2002 and 2021. The quantity and frequency of annual publications rose gradually. Regarding frequency and centrality of citations, Circulation and Clin Exp Hypertens (Clinical and Experimental Hypertension) scored top and second respectively. China had the most publications among countries/regions, as well as the five largest institutions were also in China. Cunzhi Liu was the most productive author, while P Li was the most referenced author. XF Zhao produced the first article inside the quantity of cited references classification. 'Electroacupuncture' had a significant frequency with centrality for the keywords, which suggested electroacupuncture is a popular treatment in this field. In the treatment of hypertension, electroacupuncture has a beneficial effect on reducing blood pressure. However, because of the many different applications of electroacupuncture frequencies in research, whether the electroacupuncture frequency is connected to the therapeutic impact should be given more significant consideration. The findings of this bibliometric analysis give an overview of the present state as well as developments of clinical studies on acupuncture for hypertensive patients during the last two decades, which could assist researchers in identifying hot subjects and exploring novel directions in further study within the field.

Relationship between airway epithelial barrier dysfunction and allergic asthma / 国际儿科学杂志

Airway epithelial barrier dysfunction has been observed in allergic asthma patients.Inhaled allergens have shown a disruptive effect on the airway epithelial barrier.Airway barrier related genetic variation and epigenetics are also involved in the airway epithelial barrier dysfunction.A lot of studies believe that airway epithelial barrier dysfunction underlie the development of asthma.The study of the relationship between allergic asthma and airway epithelial barrier function will be helpful to understand the pathogenesis of allergic asthma and provide new ideas for the treatment of allergic asthma.

Imaging features of plastic bronchitis in children / 中华实用儿科临床杂志

Plastic bronchitis is a rare condition characterized by bronchial casts, that may result in respiratory failure, suffocation and even death.Therefore, early diagnosis and treatment are of great significance.This article summarizes the imaging characteristics of plastic bronchitis, in order to further improve the understanding of the disease among pediatricians, radiologists, and emergency physicians.

Diabetes Mellitus Is Associated with Inferior Prognosis in Patients with Chronic Lymphocytic Leukemia: A Propensity Score-Matched Analysis.

PURPOSE: Diabetes mellitus (DM) is associated with elevated cancer risk and poor survival outcome in malignancies. The objective of this study was to evaluate the prognostic value of preexisting DM in chronic lymphocytic leukemia (CLL). MATERIALS AND METHODS: Six hundred and thirty-three subjects with newly-diagnosed CLL between 2007 and 2016 were recruited. Propensity score-matched method was performed to balance baseline characteristics and eliminate possible bias. Univariate and multivariate Cox regression analyses screened the independent risk indicators for time-to-first-treatment (TTFT) and cancer-specific survival (CSS) of CLL. Receiver operator characteristic curves and the corresponding areas under the curve assessed the predictive accuracy of CLL-International Prognostic Index (IPI) together with DM. RESULTS: The results showed that 111 patients had pre-existing DM. In the propensity-matched cohort, DM was correlated with inferior TTFT and CSS in CLL patients, and it was an independent prognostic factor for both CSS and TTFT. Pre-diabetics also shared undesirable prognostic outcome compared with patients with no diabetic tendency, and a positive association between longer diabetic duration and poorer prognosis of CLL was identified. DM as one additional point to CLL-IPI had larger area under the curve compared with CLL-IPI alone in CSS prediction and could improve the prognostic capacity of CLL-IPI. CONCLUSION: Pre-existing DM was found to be a valuable prognostic predictor and could help predict life expectancy and build refined prognostication models for CLL.

Progress of Wnt/β-catenin signaling pathway in the remodeling of asthma airway / 国际儿科学杂志

Asthma is a chronic airway inflammatory disease, and airway remodeling is one of its typical pathological features.Airway remodeling can result in hyperactivity, irreversible airflow limitation, and even decreased lung function.Studies have shown that the Wnt/β-catenin signaling pathway plays an important role in post-injury repair of the lung.Abnormal activation of the Wnt/β-catenin signaling pathway leads to airway remodeling in asthma.This article will review the progress of Wnt/β-catenin signaling pathway and asthma-related airway remodeling, and explore its possible therapeutic targets in asthma.

Diabetes mellitus predicts inferior survival in diffuse large B-cell lymphoma: a propensity score-matched analysis.

Purpose: Diabetes mellitus (DM) is associated with elevated cancer risk and poor survival. The objective of this study was to assess the prognostic value of DM in diffuse large B-cell lymphoma (DLBCL). Methods: Five hundred and fifty-three newly diagnosed DLBCL patients whose treatments included rituximab were recruited. Propensity score-matched method was performed to balance baseline characteristics and eliminate possible bias. Multivariate Cox regression analyses screened the prognostic risk factors in relation to progression-free survival (PFS) and cancer-specific survival (CSS). Receiver-operator characteristic curves and the corresponding areas under the curve (AUC) assessed the predictive accuracy of international prognostic index (IPI) together with DM. Results: One hundred and nine patients (19.71%) had pre-existing DM. In the propensity-matched cohort, DM was associated with unfavorable PFS and CSS in rituximab era, and it was an independent risk factor for both inferior PFS and CSS, especially in patients with age ≤60 years, IPI 0-2, B symptoms and lactate dehydrogenase ≤upper limit of normal. Prediabetics also demonstrated inferior prognostic outcomes compared to patients with no diabetic tendency. DM as one additional point to IPI had larger AUC compared with IPI alone in CSS prediction and could improve the prognostic capacity of IPI. Conclusion: The results indicate that preexisting DM is an important risk factor for survival. It could help predict life expectancy and build refined prognostication models for DLBCL.

Synergy between dihydromyricetin intervention and irinotecan chemotherapy delays the progression of colon cancer in mouse models.

Colorectal cancer (CRC) is the third highest cause of cancer-related death and the main option for prolonged survival is chemotherapeutic intervention. There is increasing interest in dietary intervention using natural agents to enhance the sensitivity of such invasive chemical treatment. In this study, the chemotherapeutic efficacy of dihydromyricetin (DMY) intervention on treatments involving irinotecan (CPT-11) or gemcitabine (GM) was evaluated in an AOM/DSS-induced colitis-associated colon cancer model and a Min (Apc Min/+) mice model. Our data showed that DMY could promote the CPT-11 effect both in the mouse model of AOM/DSS and Apc Min/+ cancer and had no influence on the GM effect. In AOM/DSS cancer, tumors were sensitive to 100 mg kg-1 DMY chemotherapy under 100 mg kg-1 or 200 mg kg-1 CPT-11. DMY-driven CPT-11 chemotherapy induced enhanced IgG levels and the reduction of Fusobacterium abundance in the gut. In the Min model, CPT-11 with 20 mg kg-1 DMY prevented tumor formation but not with 100 mg kg-1 DMY. Mechanically, chloride ion-dependent CFTR, CLCN4, and CLIC4 signaling are not involved in DMY mediated chemotherapeutic colon tumorigenesis. These results suggested that a suitable dose of DMY could act as a coadjuvant to CPT-11 chemotherapy.

Clinical Features of Post Cardiac Injury Syndrome Following Catheter Ablation of Arrhythmias: Systematic Review and Additional Cases.

BACKGROUND: Post cardiac injury syndrome (PCIS) is a troublesome but not uncommon complication following catheter ablation of arrhythmias. We aimed to study the clinical features of ablation-associated PCIS. METHODS: For this purpose, we conducted a computerised literature search that identified 19 published cases, and we additionally included another two new cases from our centres. Twenty-one (21) cases of PCIS following ablation were analysed. RESULTS: Among the 21 cases, PCIS most commonly occurred after atrial flutter/fibrillation (AFL/AF) ablation (71.4%), followed by atrioventricular re-entrant tachycardia (AVRT) ablation (9.5%), atrioventricular node (AVN) ablation (9.5%), atrioventricular nodal re-entrant tachycardia (AVNRT) ablation (4.8%) and ventricular tachycardia (VT) ablation (4.8%). Thirty-eight (38) per cent of PCIS was suggested to be secondary to cardiac perforation. Specific symptoms or features include pleuritic chest pain (76.2%), fever (76.2%), elevated markers of inflammation (76.2%), pericardial effusion (90.5%), pleural effusion (71.4%) and pulmonary infiltrates (28.6%). Interestingly, all the six cases with pulmonary infiltrates were following AFL/AF ablation (6/15, 40%). Serious clinical manifestations include cardiac tamponade, massive pleural effusion with hypoalbuminaemia and hyponatraemia, and massive pulmonary infiltrates with hypoxaemia. Notably, empiric antibiotic therapy was used in seven cases including five with pulmonary infiltrates but failed to work. No mortality occurred during a mean follow-up of 4.1±5.3 (1 to 19) months. CONCLUSIONS: Catheter ablation of AFL/AF was most commonly involved in ablation-associated PCIS. Pulmonary infiltrate is an important feature of PCIS following AFL/AF ablation and may be misdiagnosed as pneumonia. Although PCIS is troublesome and even dangerous, it does carry a benign prognosis.

Advance in research on sleep disorder in children with bronchial asthma / 国际儿科学杂志

Bronchial asthma in children attacks or exacerbates at night and/or in the early morning.Sleep disorders are common concomitant symptoms of nocturnal asthma, including prolonged sleep onset latency, frequent wake-ups at night, daytime sleepiness, and sleep-disordered breathing, especially in children with poor asthma control.Asthma and sleep apnea share similar risk factors, and the interaction of potential causes promotes the disease progression.When it comes to treating children with asthma, it is necessary to clear whether sleep apnea exists or not.Sleep hygiene management and the treatment of obstructive sleep apnea play an important role in the standardized treatment of childhood asthma, which could improve asthma control and the sleep quality, thereby enhancing the quality of life in children with asthma.

Effect of combined use of a low-carbohydrate, high-protein diet with omega-3 polyunsaturated fatty acid supplementation on glycemic control in newly diagnosed type 2 diabetes: a randomized, double-blind, parallel-controlled trial.

Background: The combined effect of a low-carbohydrate, high-protein (LCHP) diet and omega-3 (n-3) polyunsaturated fatty acid (PUFA) supplementation on patients with type 2 diabetes (T2D) is not known. Objective: The aim of this study was to evaluate the effect of an LCHP diet combined with ω-3 (LCHP+ω-3) on glycemic control in patients with T2D. Design: In this randomized, double-blind, parallel-controlled trial, 122 newly diagnosed participants with T2D were randomly assigned to receive a high-carbohydrate, low-protein diet with low ω-3 PUFAs [control (CON)], an LCHP, ω-3, or LCHP+ω-3 diet for 12 wk. The ratio of carbohydrate to protein was 42:28 in the LCHP and LCHP+ω-3 diet and 54:17 in the CON and ω-3 diet. The participants were given 6 g fish oil/d (containing 3.65 g docosahexaenoic acid, eicosapentaenoic acid, and docosapentaenoic acid/d) in the ω-3 and LCHP+ω-3 diet groups or 6 g corn oil/d (placebo) in the CON and LCHP diet groups. Results: Compared with the CON diet group, greater decreases in glycated hemoglobin (HbA1c) and fasting glucose were observed in all of the other 3 diet groups at 12 wk. Of note, HbA1c reduction in the LCHP+ω-3 diet group (-0.51%; 95% CI: -0.64%, -0.37%) was greater than that in the LCHP (P = 0.03) and ω-3 (P = 0.01) diet groups at 12 wk. In terms of fasting glucose, only the LCHP+ω-3 diet group showed a significant decrease at 4 wk (P = 0.03 compared with CON). Moreover, the reduction in fasting glucose in the LCHP+ω-3 diet group (-1.32 mmol/L; 95% CI: -1.72, -0.93 mmol/L) was greater than that in the LCHP (P = 0.04) and ω-3 (P = 0.03) diet groups at 12 wk. Conclusions: The LCHP+ω-3 diet provided greater effects on HbA1c and fasting glucose and faster effects on fasting glucose than both the LCHP and ω-3 diets, indicating the potential necessity of combining an LCHP diet with ω-3 PUFAs in T2D control. This trial was registered at chictr.org.cn/ as ChiCTR-TRC-14004704.

Crosstalk between gut microbiota and Sirtuin-3 in colonic inflammation and tumorigenesis.

Colorectal cancer (CRC) is a disease involving a variety of genetic and environmental factors. Sirtuin-3 (Sirt3) is expressed at a low level in cancer tissues of CRC, but it is unclear how Sirt3 modulates colonic tumorigenesis. In this study, we found that gut microbiota play a central role in the resistance to CRC tumor formation in wild-type (WT) mice through APC (Adenomatous Polyposis Coli)-mutant mouse microbiota transfer via Wnt signaling. We also found that Sirt3-deficient mice were hypersusceptible to colonic inflammation and tumor development through altered intestinal integrity and p38 signaling, respectively. Furthermore, susceptibility to colorectal tumorigenesis was aggravated by initial commensal microbiota deletion via Wnt signaling. Mice with Sirt3-deficient microbiota transfer followed by chemically induced colon tumorigenesis had low Sirt3 expression compared to WT control microbiome transfer, mainly due to a decrease in Escherichia/Shigella, as well as an increase in Lactobacillus reuteri and Lactobacillus taiwanensis. Collectively, our data revealed that Sirt3 is an anti-inflammatory and tumor-suppressing gene that interacts with the gut microbiota during colon tumorigenesis.

Dietary Factors Modulate Colonic Tumorigenesis Through the Interaction of Gut Microbiota and Host Chloride Channels.

SCOPE: In recent decades, the association among diet, gut microbiota, and the risk of colorectal cancer (CRC) has been established. Gut microbiota and associated metabolites, such as bile acids and butyrate, are now known to play a key role in CRC development. The aim of this study is to identify that the progression to CRC is influenced by cholic acid, sodium butyrate, a high-fat diet, or different dose of dihydromyricetin (DMY) interacted with gut microbiota. METHODS AND RESULTS: An AOM/DSS (azoxymethan/dextran sodium sulfate) model is established to study the gut microbiota compsition before and after tumor formation during colitis-induced tumorigenesis. All above dietary factors profoundly influence the composition of gut microbiota and host colonic tumorigenesis. In addition, mice with DMY-modified initial microbiota display different degrees of chemically induced tumorigenesis. Mechanism analysis reveals that gut microbiota-associated chloride channels participated in colon tumorigenesis. CONCLUSION: Gut microbiota changes occur in the hyperproliferative stage before tumor formation. Gut microbiota and host chloride channels, both of which are regulated by dietary factors, are associated with CRC development.

Isolation, identification and cultivation of primary rat hepatic stellate cells / 局解手术学杂志

Objeetive To improve the method for the isolation and purification of rat hepatic stellate(HSC) cells and to provide a stable cell source for the research on liver-related diseases.Methods Rat liver was digested in situ by a two-step infusion assay under a strict control of the infusion temperature,flow rate and time with a combined utilization of Pronase E and Collagenase Ⅳ.And then,the HSC cells were separated by Percoll density gradient centrifugation.The cell growth curve and survival rate were measured by CCK-8 and trypan blue staining,respectively.The HSC cells were identified by flow cytometry and immunofluorescence cytochemistry.Results With the improved methods,there were (2.1 ± 0.2) × 107 HSC cells isolated from one rat and the survival rate was (96.2 ± 0.8) ％.The percentage of HSC cells with a spontaneous fluorescent characteristic from the isolated cells was 96.3％.The immunofluorescence cytochemistry was used to detect the expressions of the surface antigens α-SMA and Desmin in the isolated HSC cells.Conclusion By strict control of infusion temperature,flow rate and perfusion time as well as the combined application of Pronase E and Collagenase Ⅳ,there is an increased harvest of HSC cells with improved cell viability and purity,which is helpful for further research on HSC cells.

Capsaicin Supplementation Improved Risk Factors of Coronary Heart Disease in Individuals with Low HDL-C Levels.

Low high-density lipoprotein cholesterol (HDL-C) is associated with an increased risk of coronary heart disease (CHD). This study aimed to evaluate the effects of capsaicin intervention on the serum lipid profile in adults with low HDL-C. In a randomized, double-blind, controlled clinical trial, 42 eligible subjects were randomly assigned to the capsaicin (n = 21, 4 mg of capsaicin daily) or to the control group (n = 21, 0.05 mg of capsaicin daily) and consumed two capsaicin or control capsules, which contained the powder of the skin of different peppers, twice daily for three months. Thirty-five subjects completed the trial (18 in the capsaicin group and 17 in the control group). The baseline characteristics were similar between the two groups. Compared with the control group, fasting serum HDL-C levels significantly increased to 1.00 ± 0.13 mmol/L from 0.92 ± 0.13 mmol/L in the capsaicin group (p = 0.030), while levels of triglycerides and C-reactive protein and phospholipid transfer protein activity moderately decreased (all p < 0.05). Other lipids, apolipoproteins, glucose, and other parameters did not significantly change. In conclusion, capsaicin improved risk factors of CHD in individuals with low HDL-C and may contribute to the prevention and treatment of CHD.

Trimethylamine-N-Oxide Induces Vascular Inflammation by Activating the NLRP3 Inflammasome Through the SIRT3-SOD2-mtROS Signaling Pathway.

BACKGROUND: Trimethylamine-N-oxide (TMAO) has recently been identified as a novel and independent risk factor for promoting atherosclerosis through inducing vascular inflammation. However, the exact mechanism is currently unclear. Studies have established a central role of nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome in the pathogenesis of vascular inflammation. Here, we examined the potential role of the NLRP3 inflammasome in TMAO-induced vascular inflammation in vitro and in vivo and the underlying mechanisms. METHODS AND RESULTS: Experiments using liquid chromatography-tandem mass spectrometry, Western blot, and fluorescent probes showed that TMAO-induced inflammation in human umbilical vein endothelial cells (HUVECs) and aortas from ApoE-/- mice. Moreover, TMAO promoted NLRP3 and activated caspase-1 p20 expression and caspase-1 activity in vitro and in vivo. Notably, a caspase-1 inhibitor (YVAD), an NLRP3 inhibitor (MCC950), as well as NLRP3 short interfering RNA attenuated TMAO-induced activation of the NLRP3 inflammasome, subsequently leading to suppression of inflammation in HUVECs. TMAO additionally stimulated reactive oxygen species (ROS) generation, in particular, mitochondrial ROS, while inhibiting manganese superoxide dismutase 2 (SOD2) activation and sirtuin 3 (SIRT3) expression in HUVECs and aortas from ApoE-/- mice. TMAO-induced endothelial NLRP3 inflammasome activation was ameliorated by the mitochondrial ROS scavenger Mito-TEMPO, or SIRT3 overexpression in HUVECs. Conversely, TMAO failed to further inhibit SOD2 and activate the NLRP3 inflammasome or induce inflammation in SIRT3 short interfering RNA-treated HUVECs and aortas from SIRT3-/- mice. CONCLUSIONS: TMAO promoted vascular inflammation by activating the NLRP3 inflammasome, and the NLRP3 inflammasome activation in part was mediated through inhibition of the SIRT3-SOD2-mitochondrial ROS signaling pathway.

Clinical Analysis of 12 cases of Systemic Lupus Erythematosus Associated with Thrombotic Thrombocytopenic Purpura / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical manifestations, treatment strategies and outcomes of 12 patients with systemic lupus erythematosus (SLE) associated with thrombotic thrombocytopenic purpura(TTP).</p><p><b>METHODS</b>The clinical data from 12 cases of SLE associated with TTP admitted in the Second Hospital of Hebei Medical University from January 2002 to August 2015 were retrospectively analyzed.</p><p><b>RESULTS</b>12 cases of SLE associated with TTP included 11 females and 1 male, their median age was 34.5 years old, among them 5 cases of TTP were diagnosed during the treatment of SLE, 7 cases of TTP were comfirmed together with SLE on admission. The hemolytic anemia, thrombocytopenia and neurological deficits appeared in all the patients, the renal impairment was observed in 10 cases, the schistocytes of peripheral blood smears (>1%) were present in 9 cases, a severely reduction of ADAMTS 13 activity (<5%) with inhibitor-positive had been demonstrated in 5 cases, all of the 12 patients were treated with glucocorticoid, and 11 cases were treated in combination with other drug(10 cases combined with cytotoxics, 1 case with intravenous gamma globulin, 1 case with rituximab), plasma exchange were used in 10 cases, and 2 cases died, 2 cases without receiving plasma exchange all died, renal damage was observed in all the dead patients.</p><p><b>CONCLUSION</b>Clinical manifestation and repeated examinations of peripheral blood smears are helpful for early diagnosis of SLE associated with TTP, the plasma exchange combined with glucocortcoids is an effective treatment method, the renal impairment may be a risk factor related with poor prognosis.</p>

Value of combining PCT, BNP, D-dimer and PCIS score in predicting the prognosis of severe pediatric pneu-monia / 临床儿科杂志

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Clinical analysis of 9 children with vertical infection of tuberculosis / 中华实用儿科临床杂志

Objective To explore the risk,diagnosis,treatment and prognosis of newborns suffering from congenital latent tuberculosis infection (CLTBI) by vertical transfer of mycobacterium tuberculosis(VTRTB) from mothers with active tuberculosis (TB) mothers during pregnancy.Methods The clinical data of 7 children with CLTBI follow-up of 1-6 years in Children's Hospital of Nanjing Medical University and 2 cases from literatures were reviewed,and they were divided into simple CLTBI group (n =5) and active TB group (n =4).Combined with the maternal history,the epidemiology,clinical features,treatment,prognosis and relative factors of the children were analyzed.Results Eight mothers had active TB during pregnancy,and premature delivery rate and low birth weight rate were 55.56％ (5/9 cases) respectively.The positive conversion rates of purified protein derivative tests (PPD),acid-fast bacilli (AFB) and TB culture were 6/9 cases,0/9 cases and 1/9 cases,respectively.Positive results of T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and TB-DNA by fluorescent quantitative polymerase chain reaction (FQ-TB-DNA) were detected in 4 cases respectively,1 of 3 patients with T-SPOT.TB and 1 of 3 patients with FQ-TB-DNA were positive.There were 5 cases with chemoprophylaxis of anti-TB drugs for 1-6 years with isonicid or rifampicin;3 cases with pulmonary hilar or mediastinal lymph nodes enlargement,and 3 cases with pulmonary diffuse punctate,nodular or patchy high density shadow in 3 cases;the rate of VTRTB in 9 cases was 8/9 (88.89％) based on laboratory examination of etiology and immunology,and the risk of active TB in infants and early childhood was close to 50％ in neonates with CLTBI;the incidence of active TB was reduced from 100％ (4/4 cases) of non-intervention down to 0 (0/5 case) of intervention.Conclusions Etiology,immunology,imaging examination of TB and clinical efficacy,can prompt active TB and retrospective diagnosis of CLTBI,and application of T-SPOT.TB and FQ-TB-DNA for early diagnosis of CLTBI has a higher applied value;prophylactic and treatment of anti-tuberculosis drugs can reduce the progression of CLTBI to active TB and improve outcomes.