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Objective: To analyze the clinical characteristics, diagnosis and treatment of anomalous aortic origin of a coronary artery (AAOCA) in children. Methods: There were 17 children diagnosed with AAOCA from January 2013 to January 2022 in Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine.Their clinical manifestations, laboratory and imaging data, treatment and prognosis were retrospectively analyzed. Results: These 17 children included 14 males and 3 females, with the age of (8.7±3.5) years. There were 4 anomalous left coronary artery (ALCA) and 13 anomalous right coronary artery (ARCA). Seven children presented with chest pain or chest pain after exercise, three patients presented with cardiac syncope, one complained chest tightness and weakness, and the other six patients had no specific symptoms. Cardiac syncope and chest tightness occurred in patients with ALCA. Fourteen children had the dangerous anatomical basis of myocardial ischemia caused by coronary artery compression or stenosis on imaging. Seven children had coronary artery repair, of whom two were ALCA and five were ARCA. One patient had received heart transplantation because of heart failure. The incidence of adverse cardiovascular events and poor prognosis in ALCA group was higher than that in ARCA group (4/4 vs. 0/13, P<0.05). They were followed up in the outpatient department regularly for 6 (6, 12) months; except for the one who lost visit, the rest of the patients had a good prognosis. Conclusions: Cardiogenic syncope or cardiac insufficiency usually occurs in ALCA, and adverse cardiovascular events and poor prognosis are more common in ALCA than in ARCA. Early surgical treatment should be considered for children with ALCA and ARCA accompanied by myocardial ischemia.
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Female , Male , Humans , Child , Child, Preschool , Retrospective Studies , China , Coronary Artery Disease , Myocardial Ischemia , Heart Failure , Chest Pain , SyncopeABSTRACT
Objective:To investigate the efficacy and adverse reactions of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with chemotherapy in the treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery.Methods:The clinical data of 72 patients with concurrent chemoradiotherapy for superior mediastinal lymph node metastasis after esophageal cancer surgery in Tai'an Cancer Prevention and Treatment Hospital from January 2019 to May 2021 were retrospectively analyzed, and they were divided into intensity-modulated radiotherapy (IMRT) group (36 cases) and SIB-IMRT group (36 cases) according to different radiotherapy methods. The short-term efficacy, long-term survival rate and adverse reactions of the two groups were compared.Results:The response rate in the IMRT group was 66.7% (24/36), the response rate in the SIB-IMRT group was 86.1% (31/36), and the difference between the two groups was statistically significant ( χ2 = 3.77, P = 0.047). The 1-, 2- and 3-year overall survival rates in the IMRT group were 75.0%, 44.4% and 27.8%, and the 1-, 2- and 3-year overall survival rates in the SIB-IMRT group were 83.3%, 52.8% and 33.3%; the difference in the overall survival between the two groups was not statistically significant ( χ2 = 0.70, P = 0.401). There were statistical differences in the incidence of leukopenia, radiation esophagitis and radiation pleural gastritis between the two groups (all P < 0.05). There were no statistical differences in the incidence of radiation pneumonia and gastrointestinal reactions between the two groups (both P > 0.05). Conclusions:SIB-IMRT combined with chemotherapy in patients with superior mediastinal lymph node metastasis after esophageal cancer surgery has good local control rate and mild adverse reactions.
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<p><b>OBJECTIVE</b>To investigate the effects of Vaspin on lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) in mice and explore the possible mechanism.</p><p><b>METHODS</b>Forty male C57B/L6 mice were randomized equally into control group, LPS group, Vaspin group and wortmannin group with corresponding treatments. The pathological changes of the lung tissues were evaluated by HE staining, and the severity of pulmonary edema was measured according to the wet/dry ratio (W/D) of the lung tissue. The lung permeability was evaluated by detecting total protein concentrations in the bronchoalveolar lavage fluid (BALF) using bicinchoninic acid (BCA) assay. Myeloperoxidase (MPO) activity in the lung tissue was detected using a MPO assay kit, and the levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the lungs were measured using ELISA. Immunohistochemical staining was performed to detect the expression of vascular cell adhesion molecule-1 (VCAM-1) and Western blotting was used to detect the protein expressions of cleaved caspase-3 and p-Akt in the lung tissues.</p><p><b>RESULTS</b>Compared with the control group, the mice in LPS group displayed typical ARDS pathological changes in the lungs with significantly increased W/D, total protein concentrations in BALF, lung MPO activity, levels of IL-1β and TNF-α, and pulmonary expressions of VCAM-1 and cleaved caspase-3 (P<0.05) but decreased expression of p-Akt (P<0.05). These changes induced by LPS were significantly alleviated by the administration of Vaspin (P<0.05). The protective effects of Vaspin against ARDS were obviously attenuated by the PI3K inhibitor wortmannin (P<0.05).</p><p><b>CONCLUSION</b>Vaspin protects against LPS-induced ARDS in mice possibly by inhibiting inflammation and protecting vascular endothelium through upregulation of the PI3K/Akt signal pathway.</p>
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<p><b>Background</b>Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.</p><p><b>Methods</b>One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.</p><p><b>Results</b>No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).</p><p><b>Conclusions</b>Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.</p>
Subject(s)
Adolescent , Adult , Humans , Male , Cross-Sectional Studies , Cryptococcosis , Allergy and Immunology , Pathology , Lung Diseases , Allergy and Immunology , Pathology , Retrospective StudiesABSTRACT
Aim To investigate the effects of Lycium barbarum polysaccharide ( LBP ) on LPS-induced ARDS in mice and the potential mechanisms. Methods Thirty-two C57BL/6 male mice were randomly divided into control group, LPS group, LBP group and LY294002 ( Akt inhibitor) group, with eight mice in each group. The pathological changes in lung tissues were evaluated by HE staining, pulmonary edema was measured by wet/dry ratio( W/D) , and the concentra-tions of total protein and the levels of inflammatory cy-tokines in BALF were determined. MDA and SOD lev-els in lung tissues and the apoptosis of lung tissues were detected. The protein expression levels of cleaved caspase-3, p-Akt and p-eNOS were determined by Western blot. Results Compared with control group, severe pathological lung injury changes were observed in LPS group, and the W/D ratio, levels of total pro-tein and inflammatory cytokines in BALF, levels of MDA in lung tissues and the expression of cleaved caspase-3 significantly increased(P<0.05), while the lung SOD activity, the p-Akt and p-eNOS expression decreased( P<0.05) . LBP could significantly attenu-ate the indexes above(P<0.05). However, the pro-tective effects of LBP on ARDS were inhibited by Akt inhibitor LY294002. Conclusions LBP protects a-gainst LPS-induced ARDS in mice by alleviating EC barrier dysfunction via the suppression of inflamma-tion, oxidative stress and apoptosis, at least partially via activation of the Akt/eNOS singaling pathway.
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Objective To investigate the effect of low pH on acid-sensing ion channel 1a( ASIC1a) expression in vascular endothelial cells induced by serum IgA 1 from Henoch-Sch?nlein purpura ( HSP ) children and regulatory role of ASIC1a in it.Methods Human dermal microvascular endothelial cells ( HDMECs) treated by serum IgA1 from children with HSP were incubated in different pH medium .ASIC1a, destrin and α-SM mRNA expressions in HDMECs were evaluated by real-time quantitative polymerase chain reaction (q-PCR).The level of inflammatory cytokines released by vascular endothelial cells was detected by ELISA .Moreover destrin and α-SM protein expres-sion in HDMECs was evaluated by Western blot .Results The results showed that in low pH condition , IgA1 from HSP children could induce the upregulation of ASIC 1a mRNA expression , stimulate IL-8, NO and TM release of vascular endothelial cells of HSP children .And blockers of ASICs could reduce acid-induced cytokine release of vascular endothelial cells .Moreover destrin and α-SM mRNA and protein expression in HDMECs of HSP children significantly decreased when exposure to extracellular acidosis .However blockers of ASICs increased destrin and α-SM mRNA and protein expression in vascular endothelial cells of HSP children .Conclusions These findings showed that activation of ASIC 1a could be involved in the vascular endothelial cell injury of HSP children .Blocking ASIC1a may have a significant protective effect on the inflammatory injury of vascular endothelial cells .
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Objective To investigate the effect of resveratrol on alveolar epithelial sodium channel in acute lung injury mice and the potential mechanism.Methods Twenty-four C57BL/6 mice were randomly divided into control group, LPS group, RES group and PP242(mTORC inhibitor) group with 6 mice in each group.The pathological changes in lung tissue were evaluated by HE staining;the concentrations of total protein in bronchoalveolar lavage fluid (BALF) were assessed by BCA (bicinchoninic acid).The levels of inflammatory cytokines in BALF were determined by ELISA.The proportions of polymorphonuclear neutrophil (PMN) in BALF were detected by Flow Cytometry.The transcription levels of α-ENaC mRNA were assessed by qPCR while the protein levels of α-ENaC and p-GSK1 were measured by Western blot.Results 1)Compared with mice in control group, severe pathological lung injury changes were observed in mice of LPS group, with increased total protein levels, PMN proportions,levels of inflammatory cytokines in BALF (P<0.05), accompanied by down-regulated level of α-ENaC and p-SGK1 in lung tissues (P<0.05).2)Compared with mice in LPS group, resveratrol significantly reversed lung injury triggered by LPS, decreased total protein levels, PMN proportions, levels of inflammatory cytokines in BALF (P<0.05), with down-regulated levels of α-ENaC and p-SGK1 in lung tissues (P<0.05).3)However, PP242 prevented beneficial effects of RES on ALI.Conclusions Up-regulation of α-ENaC expression via activation of SGK1 takes part in the protective effects of RES on LPS-induced ALI in mice.
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[ ABSTRACT] AIM:To investigate the effect of adipolin/CTRP12 in LPS-induced acute respiratory distress syn-drome (ARDS) and its potential regulation on alveolar epithelial sodium channel (ENaC) in mice.METHODS:C57BL/6J mice (n=40) were randomly divided into control group, LPS group, adipolin group and wortmannin (PI3K inhibitor) group with 10 mice in each group using random number table.The pathological changes of the lung tissues were evaluated by HE staining.The alveolar fluid clearance ( AFC) was measured by Evans blue-marked albumin, and the concentrations of total protein in bronchoalveolar lavage fluid ( BALF) were assessed by bicinchoninic acid ( BCA) method.In BALF, the levels of IL-1βand TNF-αwere determined by ELISA, and the activity of myeloperoxidase ( MPO) was detected by an MPO assay kit.The total cell counts and polymorphonuclear neutrophil ( PMN) counts in the BALF were analyzed by Gi-emsa staining.The mRNA levels of α-ENaC were assessed by qPCR, while the protein levels of α-ENaC and p-Akt were determined by Western blot.RESULTS: Compared with control group, the classic ARDS pathological changes were ob-served in the mice in LPS group, manifesting by severe pathological lung injury (P 0.05), accompanied by down-regulated levels of α-ENaC and p-Akt in the lung tissues (P<0.05).The deteriorating effects triggered by LPS were significantly reversed by administration of adipolin.However, PI3K inhibitor wortmannin can-celed the beneficial effects of adipolin on LPS-induced ARDS, as evidenced by aggravated lung injury, increased levels of W/D weight ratio, protein levels, cell counts, MPO activity, and IL-1βand TNF-αlevels in the BALF (P<0.05), and decreased levels of AFC,α-ENaC and p-Akt in the lung tissues.CONCLUSION:Adipolin protects against LPS-induced ARDS in the mice by up-regulatingα-ENaC and enhancing AFC via PI3K/Akt signal pathway.
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<p><b>OBJECTIVE</b>To investigate the protective effect of rutin against acute lung injury induced by lipopolysaccharide (LPS).</p><p><b>METHODS</b>Thirty C57BL/6 mice were randomly divided into control group, LPS-induced acute lung injury model group and treatment (LPS+Rutin) group. The pathological changes of the lung tissue were observed microscopically on paraffin sections with HE staining, and the lung wet/dry weight ratio was measured. The levels of TNF-α and IL-1β in the bronchoalveolar lavage fluid (BALF) were measured with ELISA, and the expressions of α-ENaC were detected with RT-PCR and Western blotting.</p><p><b>RESULTS</b>Pathological examination of the lung tissue revealed distinct inflammation, congestion and edema in the model group. The mice in the treatment group showed significantly milder lung injuries than those in the model group. Compared with the control group, the model group showed significantly increased lung wet/dry ratio and contents of TNF-α and IL-1β in BALF but lowered expressions of α-ENaC mRNA and protein. Compared with the model group, rutin treatment significantly decreased the lung wet/dry ratio and TNF-α and IL-1β levels in the BALF and increased the expressions of α-ENaC mRNA and protein.</p><p><b>CONCLUSION</b>Rutin can inhibit the pulmonary inflammation and increase the expression of alveolar epithelial sodium channel protein to alleviate LPS-induced acute lung injury in mice.</p>
Subject(s)
Animals , Mice , Acute Lung Injury , Drug Therapy , Bronchoalveolar Lavage Fluid , Epithelial Sodium Channels , Metabolism , Interleukin-1beta , Metabolism , Lipopolysaccharides , Lung , Pathology , Mice, Inbred C57BL , RNA, Messenger , Rutin , Pharmacology , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To review the effect of non-invasive bi-level positive airway pressure ventilation combined with naloxone in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary encephalopathy (PE).Methods Related published studies involving BiPAP combined with naloxone in the treatment of AECOPD complicated with PE were recruited and identified from Pubmed,ISI Web of knowledge,CBM Disc,CNKI,Wanfang Data,and randomized controlled trails(RCTs) primarily collected were screened according to inclusive criteria and exclusive criteria.Valid data were extracted after quality evaluation for meta-analysis utilizing RevMan 5.2.Results A total of 10 Chinese RCTs were enrolled,including 697 patients (353 patients in experimental group while 343 patients in control group).The results of metaanalysis indicated that BiPAP combined with naloxone improved PaO2 (WMD =4.10,95％ CI (2.83,5.38),P＜0.00001),PH value(WMD =0.04,95％ CI (0.02,0.05),P ＜ 0.00001) and clinical efficiency rate (OR =3.58,95 ％ CI ((2.22,5.76),P ＜ 0.00001),and reduced PaCO2 (WMD =-5.78,95 ％ CI (-6.87,4.69),P ＜ 0.00001),re-endotracheal intubation rate (OR =0.19,95 ％ CI (0.11,0.35),P ＜ 0.00001),but failed to decrease mortality(OR =0.38,95％ CI (0.11,1.34),P =0.13) of patients with AECOPD complicated with PE.Conclusions BiPAP combined with naloxone play a protective role in enhancing arterial blood gas indexes,improving clinical efficiency rate and limiting re-endotracheal intubation rate.However,the mortality of patients cannot be reduced.
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Abstract: This study is to improve the affinity of scFv-AK404R against VEGFR2. The secondary mutational library was constructed by hydrophilic shuffling in CDR3 region of the heavy chain. VEGFR2-specific screening was performed by phage display technology and the protein of mutants was expressed in periplasm of E.coli HB2151 and purified by affinity chromatography. The affinity constant of scFvs was measured by competitive ELISA, and the structure of scFvs was analyzed by bioinformatics. The result showed that a library with 6.4x10(5) scFv members was established by electro-transformation. Two mutated clones with high absorbance value were isolated after screening. After purification by affinity chromatography, electrophoretically pure scFv proteins were obtained. The competitive ELISA showed that the affinities of WZ01 and WZ02 were three times higher than that of the parental AK404R, and bioinformatics analysis showed that the enlarged contact surface and fitted closely with KDR3 surface may be the reasons for improved affinity. These results suggest that introducing hydrophilic amino acids to the heavy chain CDR3 region is an effective approach to improve the affinity of scFv.
Subject(s)
Amino Acid Sequence , Antibody Affinity , Chromatography, Affinity , Computational Biology , Enzyme-Linked Immunosorbent Assay , Escherichia coli , Metabolism , Hydrophobic and Hydrophilic Interactions , Peptide Library , Single-Chain Antibodies , Genetics , Allergy and Immunology , Vascular Endothelial Growth Factor Receptor-2 , Genetics , Allergy and Immunology , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To study the immuno-tolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells (BMSCs) in the allogeneic transplantation.</p><p><b>METHODS</b>Forty female C57BL/6 mice and forty male BALB/C mice were respectively used as donors and recipients in skin allogenic graft model. Forty male BALB/C mice were divided randomly into 4 groups: blank control group, CP group, BMSCs group , CP + BMSCs group, with 10 mice in each group. Before skin graft, high-dose abdominal injection of cyclophosphamide (200 mg/kg, 2 d, q. d.) was performed in recipient mice in CP and CP + BMSCs groups. On the transplantation day, a bonus of 2 x 10(6) BMSCs from the SD rat (SD-BMSCs) were injected through the tail vein in the BMSCs and CP + BMSCs groups. The observation and HE staining of skin grafts were used. The expressions of CD29, CD34, CD45 and CD90 of cells were analyzed by using flow cytometry in order to identify BMSCs. The CD4+, CD25+, Foxp3 and Treg cells of spleen were detected by flow cytometry. Cytokine in peripheral blood of recipient mice were measured by ELISA, including TGF-beta, IL-10 and IFN-gamma. T cells were co-cultured with 60Co-irradiated bone marrow MSCs from different individuals. The proliferative activity of T cells were evaluated with MTT assay.</p><p><b>RESULTS</b>The skin graft survival time was significantly prolonged in the CP + BMSCs group, as compared with that in the blank control group, the CP group, the BMSCs group, respectively. Cells cultured by whole bone marrow adherent cultivation showed CD29 (99.7%), CD44+ (96.7%), CD34- (1.6%), CD45- (1.3%). Compared with the control group and CP group, the ratio of the CD4+, CD25+, Foxp3+ and Treg cells significantly increased in the SD-BMSCs group and CP + BMSCs group (P < 0.05). Analysis of peripheral blood by ELISA showed significant high level of TGF-beta, IL-10 and low level of IFN-gamma in BMSCs group and CP group,compared with that in control group. When co-cultured with BMSCs from different individuals, T- lymphocytes proliferation decreased apparently in SD-BMSCs group and C57-BMSCs group (P < 0.05), but there was no significant difference between SD-BMSCs group and C57-BMSCs group (P > 0.05).</p><p><b>CONCLUSIONS</b>The immunotolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells in the allogeneic transplantation might be associated with its effect on the proliferation of Treg cells and increasing expression of TGF-beta and IL-10, decreasing expression of IFN-gamma.</p>
Subject(s)
Animals , Female , Male , Mice , Rats , Bone Marrow Cells , Allergy and Immunology , Immune Tolerance , Interferon-gamma , Allergy and Immunology , Interleukin-10 , Allergy and Immunology , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Allergy and Immunology , Mice, Inbred BALB C , Mice, Inbred C57BL , Rats, Sprague-Dawley , Skin Transplantation , T-Lymphocytes, Regulatory , Allergy and Immunology , Transforming Growth Factor beta , Allergy and Immunology , Transplantation, HomologousABSTRACT
A rapid and sensitive analytical method was developed for the simultaneous determination of fumonisins B1 and B2 in traditional Chinese medicines by HPLC-MS/MS. The detection limits for fumonisins B1 and B2 were 0.25 ng x mL(-1) corresponding to 2 microg x kg(-1) in samples. Recoveries from different samples spiked with fumonisins B1 and B2 at levels ranging from 0.2 to 3 mg x kg(-1) were 84.0%-96.1% and 86.3%-99.3%, respectively. Among the total of 34 samples purchased from local markets, ten samples of which were visibly moldy samples due to inappropriate storage, and 24 were normal samples. The results showed that 6 of the visibly moldy samples and 5 of the normal samples were contaminated with total fumonisins at levels ranging 82.4-2349 microg x kg(-1) and 102-729 microg x kg(-1), respectively.
Subject(s)
Chromatography, High Pressure Liquid , Drug Contamination , Drugs, Chinese Herbal , Chemistry , Fumonisins , Medicine, Chinese Traditional , Plants, Medicinal , Chemistry , Tandem Mass SpectrometryABSTRACT
Objective To explore the behavioral and emotional status of the migrated children one year after they were victimized from earthquake in Wenchuan. Methods 513 victimized children migrated out of disaster area were investigated, with Achenback Child Behavior Checklist ( CBCL), the Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depression Self-rating Scale for Children (DSRSC). The controls were local children ( n = 475 ) coming from the same schools. Results 487 answered files were validated. There were significant differences between the victimized and migrated children and the local children in many scores of CBCL, such as total sores( (26.73 ±6.28)Vs (20.26 ±5.76), t= 16.64, P＜0. 01 ) and withdrawal( (3.23 ±1. 68 ) Vs ( 2.02 ± 1.43 ), t = 12.91, P ＜ 0.01 ), somatization complaining( ( 2.79 ± 1. 34 ) Vs ( 1.67 ± 1.22 ), t =13.55, P ＜ 0. 01 ) and anxiety-depression scores ( ( 3.38 ± 1.79 ) Vs ( 1.95 ± 1. 21 ), t = 14.48, P ＜ 0.01 ), as well as its factors such as social problem, attentional problem, attack behavior, internalizing behavior, social communication and school scores. On the SCARED and DSRSC, the two groups were significantly different in total scores of anxiety and depression as well as in such factors as somatization, generalized anxiety, separated anxiety. Conclusion Though migrated out of the earthquake area, the victimised children still suffer obviously from behavioral problems, and anxious and depressive emotion one year after the earthquake.