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Juvenile idiopathic arthritis (JIA) is the most common chronic arthritis in childhood,and its pathological changes are similar to the inflammatory process of atherosclerosis.The traditional risk factors of cardiovascular disease include hypertension,dyslipidemia,obesity,diabetes,and so on.These risk factors may have a superposition effect on the inflammatory reaction of JIA and cause vascular endothelial dysfunction,but whether this will increase the risk of cardiovascular disease in JIA in the future,whether JIA is a new cardiovascular risk factor is still to to be confirmed.
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Juvenile idiopathic arthritis (JIA) is the most common chronic arthritis in childhood, and its pathological changes are similar to the inflammatory process of atherosclerosis.The traditional risk factors of cardiovascular disease include hypertension, dyslipidemia, obesity, diabetes, and so on.These risk factors may have a superposition effect on the inflammatory reaction of JIA and cause vascular endothelial dysfunction, but whether this will increase the risk of cardiovascular disease in JIA in the future, whether JIA is a new cardiovascular risk factor is still to to be confirmed.
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OBJECTIVE: To investigate the changes of vascular endothelial function in children with active polyarticular juvenile idiopathic arthritis(JIA)and the effects of oxidative stress and lipid metabolism on endothelial function.METHODS: Totally 42 children with active polyarticular JIA were divided into rheumatoid factor(RF)positive group and RF negative group,and 23 healthy children were randomly selected as normal control group. Brachial artery flow-mediated dilation(FMD),carotid intima-media thickness(cIMT),lipid profile and oxidative stress were measured and compared among these groups. RESULTS: Brachial artery FMD in the RF positive and the RF negative groups were significantly lower than those in the control group,especially in RF positive patients(P<0.05,respectively). There were no significant differences in c IMT.Serum TG level was significantly higher(P<0.05),while HDL-C level was significantly lower(P<0.05)in the RF-positive group compared with the control group. Serum 8-iso-PGF2α level was significantly higher(P<0.001)in the RF-positive group compared with the control group. However,significant increase in 8-iso-PGF2α level was observed in the RF negative group(P<0.01). Similarly,8-iso-PGF2α level increased more significantly in RF positive group compared with RF negative group(P<0.05). Brachial artery FMD in polyarticular JIA was negatively associated with serum 8-iso-PGF2α(r=-0.54,P<0.01). CONCLUSION: Vascular endothelial dysfunction exists in the active polyarticular JIA,especially in RF-positive patients. Increasing oxidative stress may impair the endothelial function;however,the impact of dyslipidemia on endothelial function is not clear in polyarticular JIA.
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Objective:To investigate the relationship between CD 4+CD25+regulatory T cells ( Treg) and monocyte chemoat-tractant protein-1 and its mechanism in KD pathogenesis .Methods:48 patients of KD (28 cases of recovery ,20 cases of acute phase ) were admitted from June 2014 to June 2015 and the other 40 cases of healthy children was admitted to control group .The levels of serum interleukin-15,17,23 (IL-15,17,23) and MCP-1 of two groups were measured with ELISA.The levels of Treg/Th17 cell ratio of two groups were measured with flow cytometry .Results:The levels of IL-15,IL-17,IL-23 and MCP-1 of KD group were higher than control groups(P<0.05) and the levels of IL-15,IL-17,IL-23 and MCP-1 of acute phase groups were higher than recovery groups .The levels of Th17,Treg cells,Th17/Treg of KD group were lower than the control group (P<0.05),while the levels of Th17,Treg cells,Th17/Treg cells in the acute phase of KD patients were higher than stable phase .The levels of IL-15,IL-17,IL-23 and MCP-1 and Treg/Th17 were negative correlation with univariate analysis by Pearson (P<0.05).Conclusion:The imbalance between Treg and Th17 cells and MCP-1 levels continue to rise may be associated with KD onset and progress of the disease is closely related to children in KD vivo by meas -uring children with KD Treg/Th17 cells and MCP-1 ratio of assessment Children with the condition and prognosis has some signifi-cance.
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Objective To explore the function of autonomic nerves system in children with congenital heart disease (CHD) combined with paroxysmal supraventricular tachycardia (PSVT). Methods Fifty children having PSVT and no CHD (PSVT group), 30 children with both PSVT and CHD (CHD group), and 50 cases of healthy children (control group) were selected. The difference of 24-hour heart rate variability (HRV) among three groups was analyzed retrospectively. Results There were statistical differences in the long-range time domain HRV indexes, including SDNN, SDANN, SDNN Index, pNN 50 , and RMSSD among three groups (F=80.32-?263.18, P all??0.05). The SDNN, SDANN, SDNN Index, pNN50, and RMSSD were signiifcantly decreased in CHD group compared with PSVT group (P all?
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Objective To observe the changes in red cell distribution width (RDW)and plasma N -terminal pro -brain natriuretic peptide(NT -proBNP)in children with chronic heart failure due to congenital heart disease (CHD),and to investigate their correlations with cardiac function.Methods Eighty -four children with chronic heart failure and pneumonia secondary to CHD who were hospitalized in Wuhan Health Care Center for Women and Children from January to December 201 4 were enrolled.According to the modified Ross scoring system,they were divided into 3 subgroups:mild,moderate and severe heart failure subgroups.Forty -five children with pneumonia who were hospitali-zed during the same period were randomly selected as the control group.Then the levels of RDW and plasma NT -proBNP were compared in each group,and the correlation between RDW and NT -proBNP was analyzed.Results The levels of RDW and plasma NT -proBNP in children with heart failure caused by CHD were significantly higher than those of the control group[(1 5.6 ±2.2)% vs (1 3.7 ±1 .5)%,(3 252.9 ±1 061 .5)ng/L vs (67.4 ±1 7.9)ng/L, t =5.51 8,7.838,all P 0.05].There was no signifi-cant correlation between RDMand NT -proBNP (r =0.1 34,P >0.05).Conclusions For children with CHD,higher RDW and NT -proBNP levels can aid in the diagnosis of chronic heart failure,and NT -proBNP level is associated with the severity of heart failure,yet it is still unclear whether RDW level can reflect the severity of heart failure.
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Objective To investigate the safety and efficacy of reducing pulmonary arterial pressure in patients with congeni‐tal heart disease(CHD) complicated with pulmonary hypertension(PAH) .Methods From September 2014 to January 2015 in our hospital ,34 patients with CHD complicated with PAH were selected ,all of them were treated with endothelin receptor antagonist , bosentan ,on the basis of conventional therapy .The hemodynamics observation ,cardiac function detection and six‐minute walking distance test(6 MWD)were performed after pulmonary artery pressure reducing therapy .Results After treatment ,the pulmonary vascular resistance (PVR) ,arterial oxygen saturation(SaO2 ) ,Qp/Qs and right cardiac output(CO) in these patients was (218 .30 ± 91 .25)dyn · s-1 · cm -5 ,(95 .16 ± 7 .84)% ,(1 .10 ± 0 .27) and (5 .20 ± 1 .36) L/min ,respectively ,which were better than those be‐fore treatment(P0 .05) .There was no statistically significant difference in the right ventricular diame‐ter(RVD) ,left ventricular ejection fraction(LVEF) ,three tricuspid regurgitation velocity(VP) ,three tricuspid valve transvalvular pressure difference(PGTV) ,left ventricular diastolic volume (LVEDV) and left ventricular diastolic diameter(LVEDD) before and after the treatment(P>0 .05) .After 3 months and 6 months of treatment ,6 MWD was (378 .09 ± 40 .12) and (423 .07 ± 35 .32) m respectively ,both of which were higher than those before treatment ,the differences were statistically significant (P<0 .05) .Conclu‐sion The application of bosentan therapy is safe and effective for patients with CHD complicated with PAH ,which could improve pulmonary hemodynamics and 6 MWD .
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OBJECTIVE:To investigate the effects and safety of erythropoietin on nerve function and brainstem auditory evoked potential in the preterm children with brain damage. METHODS:46 preterm children with brain damage were randomly di-vided into treatment group and control group,with 23 cases in each group. Control group received conventional symptomatic treat-ment as respiratory support,nutritional support,vitamin K supplement and ganglioside. Treatment group was additionally given rhE-PO for injection (CHO cell) 500 IU/kg hypodermically,3 times a week,on the basis of control group. Both group received 3-4 weeks of treatment continuously. MDI,PDI,the content of serum nerve injury factor(NSE,S-100β),latent period and peak inter-val of brainstem auditory evoked potential were compared between 2 groups before and after treatment,and the occurrence of ADR was observed in 2 groups. RESULTS:There was no statistical significance in MDI,PDI,the content of serum nerve injury mole-cule,latent period and peak interval of brainstem auditory evoked potential between 2 groups before treatment (P>0.05). After treatment,MDI and PDI of 2 groups increased significantly,while the content of serum nerve injury factor,latent period and peak interval of brainstem auditory evoked potential decreased significantly;the treatment group was better than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Erythropoietin can significantly im-prove intelligence development,protect the damaged nerve cells and auditory nerve pathways with good safety.
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Objective To investigate the difference of nerve behavior among the different types of fullterm small for gestational age infants(SGA) infants and the reasons.Methods The neonatal behavioral neurological assessment(NBNA) scores were given for 148 full-term SGA infants aged 7,14 and 28 days born in Affiliated Hospital of Hebei University.The comparason analysis was conducted among three types including symmetic,asymmetric and the mixture of them.Results Significant differences (P ＜ 0.05) were found between the NBNA scores for full-term SGA infants and normal infants.The NABA scores of full-term SGA infants were lower than those of normal infants.The NBNA scores for three types of full-term SGA infants followed the order of asymmetric ＞ symmetric ＞ mixture of them,significant difference was found between any two types of three types(P ＜ 0.05).Conclusion Full-term SGA infants show the poorer quality of nerve behavior compared with the nomal infants.The neurodevelopment levels for three types of full-term SGA infants are asymmetric,symmetric,mixture of them in the order.
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Objective To analyze the changes of celluar and humoral immunity in children with juvenile idiopathic arthritis(JIA),as well as the changes in different subtypes,and to investigate the role of cellular and humoral immunity in the pathogenesis of JIA.Methods Ninety-two JIA subjects and 82 controls(healthy children) were included into this study.The levels of T lymphocyte subsets,natural killer (NK)cells,and B cells were analyzed by using flow cytometry.The serum interleukin-1 (IL-1),tumor necrosis factor-α (TNF-α),interleukin-l0 (IL-10),transforming growth factor-β(TGF-β) levels were detected by using enzyme-linked imnmunosorbent assay (ELISA).The serum IgG,IgM,IgA and C3,C4 levels were detected by using velocity scatter turbidimetry.Independent t-test,One-Way ANOVA test and Pearson analysis were adopted for data analysis.Results 1.In the group of JIA,the levels of CD3,CD4,IL-1,TNF-α,IgG,IgM,IgA and C3 were higher than those in the control group(all P ＜ 0.05),while the levels of CD4CD25,CD8,NK cells,IL-10 and TGF-β were lower than those in the control group(all P ＜0.05),and the ratio of CD4/CD8 was higher than that in the control group (P ＜ 0.05).2.In the group of systemic-onset JIA (so-JIA),the levels of CD4,IL-1,TGF-β,IgG,IgM,IgA,C3 and the ratio of CD4/CD8 were higher than those in the oligoarthritis JIA group(all P ＜ 0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group(all P ＜ 0.05).In the group of polyarthritis JIA,the levels of IL-1,TNF-α,IgG,IgM and IgA were higher than those in the oligoarthritis JIA group(all P ＜0.05),while the levels of CD4CD25,CD8,IL-10 were lower than those in the oligoarthritis JIA group (all P ＜ 0.05) ; In the group of so-JIA,the levels of CD4,TGF-β,C3 and C4 were higher than those in the polyarthritis JIA group (all P ＜ 0.05).3.The value of IL-1,TNF-α were positively correlated with that of C-reactive protein (CRP),erythrocyte sedimentation rate(ESR) in the JIA group(all P ＜ 0.05),while the value of IL-10,TGF-β was negatively correlated with that of CRP,ESR(all P ＜ 0.05).Conclusions There are cellular immunity and humoral immunity disorders in the JIA.Cellular immunity and humoral immunity are all involved in the pathogenesis of JIA.T helper cells are activated and Th1 cytokines increase,suppressive T cells,regulatory T cells impairment and suppressive cytokines decrease but immunoglobin increase,which involve in auto inflammation reaction and articular destruction in JIA.The immunity disturbances are more striking in so-JIA and polyarthritis JIA.IL-1,TNF-α,IL-10 and TGF-β are correlated with the disease activity.
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Objective To determine the etiology and clinical characteristics of children with dilated cardiomyopathy.Methods 112 children with DCM from January 2002 to December 2011 were studied.The age,cause and the clinical manifestations were analyzed.According to the children with heart function,they were divided into four groups,the incidence and type of arrhythmia were compared.Results In 112 cases of DCM in children,＜ 1 year old diagnosed 52 cases (46.42％),107 cases (95.53％) with heart failure,25 cases (22.32％) with chear causes,96 cases(85.71％) children with a variety of arrhythmias.According to cardiac function in Ⅰ,Ⅱ and Ⅲ and Ⅳ level,they were divided into four groups.The incidence of one kind of arrhythrnia were 20.00％,31.25％,36.17％ and 42.85％.The incidence with two or more kinds of arrhythmia was 0,18.75％,38.29％ and 50.00％ respectively.The incidence of malignant arrhythmia was 0,12.50％,40.42％and 67.85％ in different groups.There was significant differences among the groups of Ⅱ and Ⅲ and Ⅳ level (P ＜ 0 05).Conclusion Children with dilated cardiomyopathy disease younger than I year old had the highest incidence.The major causes were myocarditis,hereditary and congenital metabolic diseases.The incidence of arrhythmia in DCM were high and diverse,often exist for a variety of arrhythmia,and arrhythmia have closely relation with heart function.The embolism in children with DCM was very rare.
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Objective To monitor the levels of NO and IL-18 in neonatal hypoxic-ischemic encephalopathy (HIE), to explore the relation of NO, IL-18 and HIE. Methods HIE infants admitted in our hospital from January to Novermber of 2007 were taken as observation group and normal neonates were chosen as control group. In each group,the concentrations of NO and IL-18 were tested on 1 day,3 days,7 days and 14 days. Results On the first day after birth,the levels of serum NO and IL-18 in control group were (6.40±4.24) μmol/L and (2.84± 2.53)ng/L,in mild HIE group were (21.55±7.23) μmoL/L and (6.79±1.96) ng/L,in moderate HIE group were (33.38±2.81) μmol/L and (14.07±2.91) ng/L,in severe HIE group were (66.39±18.03) μmoL/L and (26.85±9.82) ng/L. The levels of serum NO and IL-18, in HIE groups were higher than those in control group (P<0.01), were much higher in patients with moderate and severe HIE than those with mild HIE (P<0.01). On 14 days,the levels of serum No and IL-18 were not different in moderate HIE groups and those in the control group (P>0.05), butwere higher in the severe HIE groups than those in the control group [NO and IL-8 level: (5.38± 4.79) μmol/L and (2.39±1.41) ng/L in control group and (24.89±9.43) μmol./L and (13.43±3.23) ng/L in severe HIE group(P<0.01)]. Conclusion NO and IL-18 are involved in the whole course of HIE, which are correlated with the severity of condition. They may be acted as indicators in monitoring pationts' conditon.
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Objective To study the mechanism of interaction between neuronal nitric oxide syn-thase (nNOS) and inducible nitric oxide synthase (iNOS) following traumatic brain injury (TBI) in rats. Methods A total of 250 male Wistar rats were randomly divided into five groups, ie, sham oper-ation group, trauma group, 7-nitroindazole (7-NI) treatment group, aminoguanidine (AG) treatment group and combined AG and 7-NI treatment group. Severe closed TBI was made by using Marmarou meth-od. Protein expressions of nNOS and iNOS in hippocampus CAI were detected by means of immunohisto-chemical staining at 1,3, 6, 12 hours and at days 1,3, 7 and 14 after TBI. Results The expression of nNOS reached a peak at 6 hour after injury in all groups, with no statistical difference between groups (P > 0. 05), when there was no statistical difference between 7-NI treatment group and trauma group (P > 0. 05) but statistical difference in AG treatment group and combined AG and 7-NI treatment group compared with trauma group at 12 hours after TBI (P <0.05). The expression of iNOS reached maximal level at day 3 after TBI, with lower level in 7-NI group, AG treatment group and combined AG and 7-NI treatment group compared with trauma group (P < 0.05). Conclusions After TBI, nNOS interacts with iNOS by means of the feedback of nitric oxide. The enhanced expression of nNOS is initial factor for increase of iNOS expression, which can down regulate the expression of iNOS.
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In order to learn the tissuse perfusion and oxygenization in the patient with septic shock (SS) in Qinghai plateau,25 cases having suffered from SS in Xining,the capital of Qinghai province, were divided into death group (group D) and survival group(group S), and the data of oxygen dynamics, determined by Swan-Ganz cathter and thermodilution methods,were analyzed retrospectively. The results showed that the oxygen delivery (DO_2) and oxygen consumption (VO_2) increased to varying degrees in all of cases;VO_2 was positively correlated with DO_2, and in group D the correlation remained significant during whole duration of disease,but in group S it became unsignificant as DO_2 was above 700 ml?min~(-1)?m~(-2); the oxygen extraction rate decreased markedly in both groups,but much more in group D. These suggest that the insufficient oxygenization of general tissuse in patient with SS results from the dysfunction of oxygen extraction,and increasing DO_2 is helpful for the shock resuscitation except VO_2 is persistently and positively correlatded with DO_2.