Continuous renal replacement therapy in children with multiple organ dysfunction syndrome: a case series.

There is a lack of definitive information regarding the precise indications, implementation, and outcomes of continuous renal replacement therapy (CRRT) for the treatment of critically ill children. Six children (three boys, three girls) aged from 3 days to 8 years, all of whom had multiple organ failure, were submitted to bedside CRRT using M60 filter membranes. Modified Port carbonate formula was used and clotting time was maintained between 20 and 30 minutes. Activated partial thromboplastin time was 1.5- to 2-fold normal. One patient discontinued treatment due to family decision. Marked improvements were seen in the remaining five patients, including normalization of blood urea nitrogen and creatinine levels, stabilization of electrolytes, and improvements in markers of organ function. Of note, one patient (a six-year-old male) underwent the treatment for 241 hours. All five patients were subsequently discharged and recovered uneventfully. CRRT is effective for the management of children who are critically ill due to multiple organ failure.

Novel characteristics for immunophenotype, FISH pattern and molecular cytogenetics in synovial sarcoma.

As a rare and highly aggressive soft tissue sarcoma, the new immunophenotype, atypical FISH pattern and relevant molecular cytogenetics of synovial sarcoma (SS) remain less known, although it is characteristically represented by a pathognomonic chromosomal translocation t (X; 18) (p11.2; q11.2). Methodologically, the morphology was retrospectively analysed by using H&E staining, and immunohistochemical features were investigated by using markers that have been recently applied in other soft tissue tumors. Moreover, FISH signals for SS18 and EWSR-1 break-apart probes were examined. Finally, cytogenetic characteristics were analysed via RT-PCR and Sanger sequencing. Consequently, nine out of thirteen cases that were histologically highly suspected as SS were finally identified as SS via molecular analysis. Histologically, nine SS cases were divided into monophasic fibrous SS (4/9), biphasic SS (4/9) and poorly differentiated SS (1/9). Immunohistochemically, SOX-2 immunostaining was positive in eight cases (8/9) and PAX-7 immunostaining was diffusely positive in the epithelial component of biphasic SS (4/4). Nine cases showed negative immunostaining for NKX3.1 and reduced or absent immunostaining for INI-1. Eight cases showed typically positive FISH signalling for the SS18 break-apart probe, whereas one case exhibited an atypical FISH pattern (complete loss of green signalling, case 2). Furthermore, the SS18-SSX1 and SS18-SSX2 fusion genes were identified in seven cases and two cases, respectively. The fusion site in 8 out of 9 cases was common in the literature, whereas the fusion site in case 2 was involved in exon 10 codon 404 in SS18 and exon 7 codon 119 in SSX1 (which has not been previously reported), which notably corresponded to the complete loss of green signalling in the FISH pattern. Additionally, FISH analysis of the EWSR-1 gene in nine SS cases demonstrated aberrant signalling in three cases that were recognized as a monoallelic loss of EWSR-1 (1/9), an amplification of EWSR-1 (1/9) and a translocation of EWSR-1 (1/9). In conclusion, SS18-SSX fusion gene sequencing is obligatory for a precise diagnosis of SS when dealing with a confusing immunophenotype and atypical or aberrant FISH signalling for SS18 and EWSR-1 detection.

Changes in sensory characteristics, chemical composition and microbial succession during fermentation of ancient plants Pu-erh tea.

"Ancient tea plants" are defined as tea trees > 100 years old, or with a trunk diameter > 25 cm; their leaves are manufactured to high - quality, valuable ancient plants pu-erh tea (APPT). In this study, a fermentation of APPT were developed, and outstanding sweetness of APPT infusion was observed. During fermentation, the content of soluble sugars, theabrownins (p < 0.05), as well as 41 metabolites were increased [Variable importance in projection (VIP) > 1.0; p < 0.05 and Fold-change (FC) FC > 2]; While relative levels of 72 metabolites were decreased (VIP > 1.0, p < 0.05 and FC < 0.5. Staphylococcus, Achromobacter, Sphingomonas, Thermomyces, Rasamsonia, Blastobotrys, Aspergillus and Cladosporium were identified as dominant genera, and their relative levels were correlated with contents of characteristic components (p < 0.05). Together, changes in sensory characteristics, chemical composition and microbial succession during APPT fermentation were investigated, and advanced the formation mechanism of its unique quality.

The effect of fetal congenital heart disease on in utero urine production rate.

OBJECTIVES: To evaluate the influence of congenital heart disease (CHD) or congestive heart failure (CHF) on fetal urine production rate (UPR) and to establish normal reference intervals. METHODS: A cross-sectional study was performed on normal fetuses (n = 314) and on fetuses with CHD (n = 49). CHD cases were divided into groups on the basis of heart function as defined by Huhta score: with CHF (n = 11) and without CHF (n = 38). Fetal bladder volume was measured by two-dimensional as well as three-dimensional ultrasound with the Virtual Organ Computer-aided Analysis technique. RESULTS: In normal fetuses, UPR increased with gestational age from a mean value of 4.5 mL/h at 21 weeks to 66.5 mL/h at 40 weeks. There were no significant differences in UPR between CHD cases without CHF and controls (P = 0.581). However, fetuses with CHF had decreased UPR values (Controls vs. CHF, P = 0.007) compared with the controls. The interobserver and intraobserver variability for assessment of UPR was better using three-dimensional rather than two-dimensional US. CONCLUSIONS: Fetal UPR can be reproducibly measured by the Virtual Organ Computer-aided Analysis technique. It appears that heart function, rather than CHD, affects fetal UPR. Fetal UPR may therefore be an additional indicator of CHF.

Tunable microring resonator based on dielectric-loaded surface plasmon polariton waveguides.

Integrated optical ring resonators are essential elemental components for integrated optical circuits. An ultrasmall thermo-optical microring resonator with two bus waveguide-configuration based on surface plasmon polariton waveguide is theoretically analyzed. The thermo-optical coefficient, the temperature-dependent amplitude attenuation coefficient and the temperature distribution properties of the waveguide are investigated numerically by finite element method. The critical resonant conditions of the microring resonator are discussed by considering the propagation losses in the plasmonic ring cavity. The transmission characteristics and the tunability of the ring resonator with different structural parameters are investigated. The results show that the proposed ring resonator with a low driving power and high efficient tunability has potential to develop nano-scope wavelength tunable channel drop filters, low power optical switches, attenuators, and other high compact integrated optical devices.

Association between carotid artery perivascular fat density and cerebral small vessel disease.

Studies aiming to identify the significance of the carotid artery perivascular fat density are limited. The present study investigated the distribution pattern of pericarotid fat and its association with imaging markers of cerebral small vessel disease (CSVD). In total, 572 subjects who underwent both neck computed tomography angiography and cranial magnetic resonance imaging were analyzed. The pericarotid fat density near the origin of the internal carotid artery (ICA) and imaging markers of CSVD, such as lacunes, white matter hyperintensities (WMHs) and dilated perivascular spaces (PVSs), were assessed. We found that an increased pericarotid fat density was associated with the presence of lacunes and a higher WMH grade in all subjects, but in the patients with acute ischemic stroke, there was a difference only among the WMH grades. There was no significant difference in the pericarotid fat density in different grades of PVSs. The patients with acute ischemic stroke had a significantly higher mean pericarotid fat density than those without stroke. In conclusion, our study provides evidence suggesting that an increased pericarotid fat density is associated with the presence and degree of WMHs and lacunes. Our findings suggested that features that appear to extend beyond the vessel lumen of the ICA may be linked to CSVD.

[Association of the ALOX5AP gene SG13S114 A/T polymorphism with atherosclerosis].

OBJECTIVE: To investigate the relationship between the polymorphism of SG13S114 A/T in the 5-lipoxygenase-activating protein (ALOX5AP) gene and the stability of carotid atherosclerosis. METHODS: Polymorphism of SG13S114 A/T in the ALOX5AP gene was analyzed in 152 cases of acute infarction with stable plaque, and 132 cases of acute infarction with vulnerable plaques, by using polymerase chain reaction and restriction fragment length polymorphism. Carotid artery plaque was analyzed by carotid artery color ultrasound. RESULTS: The frequencies of SG13S114 AA genotype and the A allele in the vulnerable plaque group were higher than that in the stable plaque group (P< 0.01). CONCLUSION: The polymorphism of SG13S114 A/T in the ALOX5AP gene may be associated with the instability of atherosclerosis. And the SG13S114 A allele may be a risk factor of vulnerable plaques.

Primary malignant gastrointestinal neuroectodermal tumor occurring in the ileum with intra-abdominal granulomatous nodules: A case report and review of the literature.

Malignant gastrointestinal neuroectodermal tumors (GNETs) are rare aggressive malignant neoplasms that exclusively occur within the wall of the gastrointestinal tract. The GNET was first described as an 'osteoclast-rich tumor of the gastrointestinal tract with features resembling clear cell sarcoma (CCS) of soft parts' in 2003. Although the GNET shares certain histological features with CCS, it is characterized by a lack of melanocytic differentiation and the presence of non-tumoral osteoclast-like giant cells (OLGCs). The present study reports a case of a GNET of the ileum with intra-abdominal granulomatous nodules, an uncommon accompanying finding, and summarizes the current literature. A 30-year-old woman presented with the symptoms of intestinal obstruction, and a mass was found within the ileum wall. Multiple grey-white nodules were found adhering to the omentum and serosa of the ileum. Histologically, the tumor was located in the muscularis propria and infiltrated the mucosa and the serosa. Tumor cells presented with oval or polygonal nuclei and prominent nucleoli, and were predominantly arranged in nested and pseudopapillary patterns, with the presence of cluster of differentiation (CD)68-positive, scattered OLGC. Immunohistochemically, it was determined that the tumor cells expressed Vimentin, CD56, S-100 and transcription factor SOX-10, while being negative for pan-cytokeratin, cytokeratin (CK)7, CK20, synaptophysin, chromogranin-A, CD117, anoctamin-1, CD34, human melanoma black-45, Melan-A, smooth muscle actin, CD3 and CD20 expression. Ewing sarcoma breakpoint region 1 gene rearrangement was identified by fluorescence in situ hybridization analysis. Ultrastructurally, no typical melanosomes were identified. In addition, the intra-abdominal grey-white nodules were microscopically identified as chronic granulomatous inflammation. The patient received four cycles of adjuvant chemotherapy following routine tumor resection. Due to its rarity and histological similarity with other neoplasms, unfamiliarity with the features of GNETs by surgical pathologists can easily lead to a misdiagnosis. Therefore, comprehensive assessments, including morphology and ancillary studies, are required for an accurate diagnosis of GNET.

[Study on expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 in brain tissue adjacent to hemorrhage after brain hemorrhage in human].

OBJECTIVE: To investigate the expression and significance of matrix metalloproteinase-2 (MMP-2) and MMP-9 in peri-hematoma brain tissues after acute brain hemorrhage in human. METHODS: Forty-two patients with acute brain hemorrhage received surgery, the brain tissues adjacent to hemorrhagic site were obtained during surgery, and positive expressions of MMP-2 and MMP-9 were determined with immunohistochemical staining. Brain tissues from 30 patients with cerebral trauma were obtained to serve as controls. RESULTS: The positive expressions of MMP-2 and MMP-9 in focal brain tissues were significantly elevated in early acute brain hemorrhage. Compared with 28 and 27 cases with MMP-2 and MMP-9 positive expression respectively in control group, there were 39 and 37 cases with MMP-2 and MMP-9 positive expression respectively in acute brain hemorrhage group. There were no significant differences between two groups (both P>0.05). CONCLUSION: MMP-2 and MMP-9 might contribute to brain edema formation in the acute intra-cerebral hemorrhage of human.

Structure-based design, structure-activity relationship analysis, and antitumor activity of diaryl ether derivatives.

To identify novel therapeutic agents to treat cancer, we synthesized a series of diaryl ether derivatives. Structure-activity relationship studies revealed that the presence of a chlorine or hydroxyl at the para-position on the phenyl ring (5h or 5k) significantly enhanced antitumor activity. Compound 5h had stronger growth inhibitory activity in HepG2, A549, and HT-29 cells than compound 5k, with IC50 values of 2.57, 5.48, and 30.04 µM, respectively. Compound 5h also inhibited the growth of other cells lines, including Hep3B, PLC/PRF5, SMMC-7721, HeLa, and A375, with IC50 values of 2.76, 4.26, 29.66, 18.86, and 10.21 µM, respectively. The antitumor activity of compound 5h was confirmed by a colony forming assay. Further, our results indicated that the antitumor activity of compound 5h may be mediated by enhancing expression of p21 and cl-caspase3, and leading to apoptosis of cancer cells.

Up-regulating of RASD1 and apoptosis of DU-145 human prostate cancer cells induced by formononetin in vitro.

Prostate cancer is one of the most prevalent malignant cancers in men. The isoflavone formononetin is a main active component of red clover plants. In the present study, we assessed the effect of formononetin on human prostate cancer DU-145 cells in vitro, and elucidated possible mechanisms. DU-145 cells were treated with different concentrations of formononetin and cell proliferation was assessed by MTT assay, cell apoptosis by Hoechst 33258 and flow cytometry, and protein levels of RASD1, Bcl-2 and Bax by Western blotting. The results showed that formononetin inhibited the proliferation of DU-145 cells in a dose-dependent manner. DU-145 cells treated with different concentrations of formononetin displayed obvious morphological changes of apoptosis under fluorescence microscopy. In addition, formononetin increased the proportion of early apoptotic DU-145 cells, down-regulated the protein levels of Bcl-2 and up-regulated those of RASD1 and Bax. The level of RASD1 reached its maximum at 48 h post-treatment, and rapidly decreased thereafter. Together, we present evidence that formononetin triggered cell apoptosis through the mitochondrial apoptotic pathway by up-regulating RASD1.

[The relationship between the levels and variability of blood glucose and the prognosis of massive cerebral infarction].

OBJECTIVE: To investigate the relationship between the levels and variability of blood glucose and the prognosis of massive cerebral infarction. METHODS: A retrospective study involving 72 massive cerebral infarction patients without diabetes mellitus admitted to Taizhou Enze Medical Centre Luqiao Hospital from January 2012 to June 2013 was conducted. The mean blood glucose level (GluAve), standard deviation of blood glucose level (GluSD), and coefficient of variation of blood glucose level (GluCV) during the first 72 hours were monitored. Complications such as cerebrocardiac syndrome, pulmonary infection, stress ulcer bleeding, urinary system infection, decubitus sore, electrolyte disturbances, and epileptic seizures were also recorded. According to the 28-day outcome after admission, patients were divided into survivor group (n=60) and non-survivor group (n=12). The values of GluAve, GluSD and GluCV were compared between the two groups. The patients were again divided into three groups based on the level of GluAve (<7.8, 7.8-11.1, >11.1 mmol/L). Finally, patients were divided into four groups based on the level of GluCV (<15%, 15%-30%, 30%-50%, >50%). Acute physiology and chronic health evaluation II (APACHEII) score, mortality, and complications were compared among groups. RESULTS: The levels of GluAve, GluSD and GluCV in non-survivor group were significantly higher than those in survivor group [GluAve: 17.91 ± 5.33 mmol/L vs. 12.41 ± 3.12 mmol/L, t=3.145, P=0.002; GluSD:2.87 ± 1.96 mmol/L vs. 1.83 ± 1.08 mmol/L, t=2.611, P=0.017; GluCV: (27.56 ± 14.73)% vs. (20.12±10.97)%, t=2.020, P=0.043]. With the gradual increase of GluAve level, the mortality and total complication rate were elevated significantly [28-day mortality: 5.00% (1/20), 13.89% (5/36), 37.50% (6/16), χ²=7.16, P=0.028; total complication rate: 35.00% (7/20), 55.56% (20/36), 93.75% (15/16), χ²=12.85, P=0.002]. But there was no significant difference in APACHEII score (9.80 ± 4.17, 12.11 ± 5.81, 13.69 ± 6.57, F=2.241, P=0.114) and stress ulcer incidence rate [5.00% (1/20), 11.11% (4/36), 31.25% (5/16), χ²=5.59, P=0.061]. With the gradual increase of GluCV level, APACHEII score, 28-day mortality, the incidence of various complications, and total complication rate were all raised significantly [APACHEII score: 7.00 ± 1.56, 10.08 ± 1.88, 13.14 ± 5.76, 16.76 ± 7.17, F=12.486, P=0.000; mortality: 0 (0/15), 8.70% (2/23), 23.81% (5/21), 38.46% (5/13), χ²=9.27, P=0.026; total complication rate: 40.00% (6/15), 47.83% (11/23), 57.14% (12/21), 100.00% (13/13), χ²=12.42, P=0.006]. CONCLUSIONS: Both the GluAve level and GluCV level are significantly correlated with the outcome of patients suffering from massive cerebral infarction. The change in GluCV level seems to be more sensitive in predicting the prognosis of massive cerebral infarction than GluAve.

Continuous renal replacement therapy in children with multiple organ dysfunction syndrome: A case series

There is a lack of definitive information regarding the precise indications, implementation, and outcomes of continuous renal replacement therapy (CRRT) for the treatment of critically ill children. Six children (three boys, three girls) aged from 3 days to 8 years, all of whom had multiple organ failure, were submitted to bedside CRRT using M60 filter membranes. Modified Port carbonate formula was used and clotting time was maintained between 20 and 30 minutes. Activated partial thromboplastin time was 1.5- to 2-fold normal. One patient discontinued treatment due to family decision. Marked improvements were seen in the remaining five patients, including normalization of blood urea nitrogen and creatinine levels, stabilization of electrolytes, and improvements in markers of organ function. Of note, one patient (a six-year-old male) underwent the treatment for 241 hours. All five patients were subsequently discharged and recovered uneventfully. CRRT is effective for the management of children who are critically ill due to multiple organ failure.