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Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ2=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ2=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.
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Child , Child, Preschool , Female , Humans , Male , Cardiopulmonary Resuscitation , Heart Arrest/therapy , Heart Defects, Congenital/therapy , Intensive Care Units, Pediatric , Retrospective StudiesABSTRACT
Many drug candidates identified from natural products are poorly water-soluble. The surfactants used to disperse the hydrophobic anticancer drugs in water may cause a serious of acute hypersensitivity reactions. Nanotech?nology provides an alternative strategy for delivery of anticancer drugs. Drugs can be encapsulated or attached to the nanomaterials such as lipids, polymers and solid-core nanoparticles. In the present study, porous inorganic nanoparti?cles have been utilized for delivery of water-insoluble anticancer drugs. The synthesized nanoparticles were functional?ized with different organic polymers. The porous nanoparticles were readily internalized by human glioblastoma U-87 MG cells, and didn't display cytotoxicity. The internalized nanoparticles were mainly localized in endosomes/lysosomes in cells. With the hydrophobic curcumin and carfilzomib as model drugs, intracellular delivery of hydrophobic anticancer drugs by the porous inorganic nanoparticles was studied. The porous nanoparticle-based encapsulation of hydrophobic drug provides the aqueous dispersion of the drugs. In endosomes/lysosomes mimicking buffers with a pH of 4.5-5.5, pH-dependent drug release was observed from drug loaded nanoparticles. The intracellular drug content and cytotoxicity were significantly higher for drug loaded nanoparticles than free drug. These results suggested porous inorganic nanoparticles might be a promising intracellular carrier for hydrophobic anticancer drugs.
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Objective There are few reports on the relationship between lncRNA cancer susceptibility candidate gene 2 (CASC2) and NF-κB signaling pathway in thyroid papillary carcinoma cells at home and abroad. This study aimed to investigate the effect of lncRNA CASC2a on the proliferation and migration of TPC-1 via NF-κB signaling pathway. Methods TPC-1 was selected and constructed into lncRNA CASC2a overexpression plasmids which were divided into plasmid group [transfection with overexpressed plasmid pcDNA3.1(+)-CASC2a], empty group [transfection with equal amount of pcDNA3.1 (+) empty plasmid], blank group (without any processing). The effect of overexpressed lncRNA CASC2a on the expression of CASC2a in each group of TPC-1 cells was examined. The cells of transfected plasmid group were randomly divided into transfection group [transfection with only overexpressed plasmid pcDNA3.1(+)-CASC2a], transfection + PMA group [transfection with overexpressed plasmid pcDNA3.1(+)- CASC2a + propylene glycol methyl ether acetate (PMA) stimulation], control group (without any processing), PMA group (only plus PMA stimulation). The effects of lncRNA CASC2a on cell proliferation and migration were verified by CCK-8 and cell scratch assays at 24, 48, 72 and 96 h. Western blot was used to detect the expression of p105/p50 and p65 in NF-κB signaling pathway. The expression of NF-κB signaling pathway-related antibody proteins p105/p50 and p65 was observed by NF-κB signaling pathway agonist PMA(propylene glycol methyl ether acetate). Results After transfection with overexpressed plasmid pcDNA3.1(+)-CASC2a, the expression of CASC2a in plasmid group was significantly higher than that in empty group (P<0.05). The cell proliferation ability (0.191±0.005) was significantly lower in transfection+PMA group than that in transfection group (0.217±0.013), PMA group (0.247±0.009), and control group (0.260±0.004), and the difference was statistically significant ( P<0.01), while the cell proliferation ability in transfection group was significantly lower than those in PMA group and control group (P<0.01). The cell migration ability of transfected + PMA group [(0.208±0.109)%] was lower than that of transfection group, PMA group, and control group [(1.775±0.061)%, (1.622±0.519)%, (2.927±0.136)%], while the cell migration ability of transfection group and PMA group was lower than that in control group (P<0.05). The relative expression of p105/p50 and p65 protein in plasmid group was significantly lower than that in blank group (P<0.05). The expression of p105/p50 and p65 protein in transfection+PMA group [(0.674±0.007), (0.713±0.014)] was significantly higher than that in transfection group [(0.581±0.003), (0.570±0.012)] (P<0.05). Conclusion lncRNA CASC2a may inhibit the proliferation and migration of thyroid papillary carcinoma cells through NF-κB signaling pathway.
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Objective To study the expression of Pim1 protein in variant lesions of esophagus and its correlation with the clinicopathological parameters of esophageal cancer patients.Methods The esophageal biopsy specimens of 182 cases,including 37 cases of normal squamous epithelium,43 cases of low-grade intraepithelial neoplasia,31 cases of high-grade intraepithelial neoplasia,71 cases of esophageal squamous cell carcinoma were collected in the Third Affiliated Hospital of Xinxiang Medical University From January 2009 to March 2016.The expression of Pim1 protein in all esophageal tissues was detected by immunohistochemical method,and the correlation between Pim1 protein expression and clinicopathological parameters of esophageal squamous cell carcinoma patients was analyzed.Results The higher expression rate of Pim1 protein in esophageal normal squamous epithelium,low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia and esophageal squamous cell carcinoma was 24.3％ (9/37),62.8 ％ (27/43),70.9％ (22/31),and 76.1％ (54/71),respectively.The higher expression rate of Pim1 protein in the tissue of low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia and esophageal squamous cell carcinoma was significanlty higher than that in the esophageal normal squamous epithelium(x2 =11.89,14.79,26.70;P ＜ 0.05);there was no statistic difference of the higher expression rate of Pim1 protein in the tissue of low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia and esophageal squamous cell carcinoma (P ＜ 0.05).The expression of Pim1 protein was significantly positively correlated with lymph node metastasis and TNM stage(P ＜0.05),but not correlated with age and histological grade of patients (P ＜ 0.05).Conclusion The expression of Pim1 protein is closely related to the occurrence and development of esophageal cancer.
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This study was designed to analyze the change of metabolites in the PC12 cells and its medium induced by corticosterone (CORT) and glutamate (Glu) by proton nuclear magnetic resonance (1H NMR) metabolomics. The multivariate statistical analysis was employed to identify the difference between control groups and induced groups, respectively. In addition, metabolite pathway analysis was performed to explore the characteristic of CORT-induced and or Glu-induced PC12 cells depression model, and to provide the references for the selection of in vitro depression models as well as the further understanding of the mechanism on depressive disorders. We found 36 differential metabolites in CORT-induced PC12 cells and medium and 42 in Glu-induced PC12 cells. Furthermore, correlation analysis results show that serine and 2-oxoisoleucine were associated with most differential metabolites in CORT-induced PC12 cells. Lactate and glutathione were significantly correlated to the vast majority of differential metabolites in Glu-induced PC12 cells. We speculated that CORT-induced PC12 cell models may affect the fatty acid metabolism and cell membrane structure, and Glu-induced PC12 cell models may have a difference in the glycolysis and antioxidants.
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The study was designed to clarify the antidepressant mechanism of supercritical CO2 extract from Compound Chaigui Fang. We used TCMSP, HIT, Pharm GKB and Gene Cards bioinformatics software to predict and analyze the drug/disease targets and their common targets of compounds in the supercritical CO2 extract of Compound Chaigui Fang for depression. Chronic unpredictable mild stress (CUMS) was used to induce depressed model in rats. Hippocampus and serum were collected after supercritical CO2 extract treatment to detect the potential antidepressant targets with enzyme-linked immunosorbent assay (ELISA). The results predicate that there are 22 chemical compounds and 78 potential therapeutic drug targets for depression. There are 177 disease markers for depression, and 14 common targets for drug intervention of depression, which includes the neurotransmitter transports/metabolic enzyme/receptors, hormone of hypothalamus-pituitary-adrenal/thyroid/gonad axis, immune-associated factor, etc. ELISA results suggest that depression is associated with the low level of phosphate cAMP responsive element-binding protein in hippocampus and the high levels of corticosterone and interleukin 6 in serum with CUMS rat. Those were restored to normal levels by supercritical CO2 extract of Compound Chaigui Fang. The study provides an antidepressant mechanism of supercritical CO2 extract of Compound Chaigui Fang based on the network pharmacology, and a new strategy in the study of the effective extracts of compound Chinese traditional medicine.
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To elucidate the anti-depressive effect of Fufang Chaigui prescription and its mechanism and investigate its effect on neuroendocrine hormone, rats were included into a chronic unpredictable mild stress (CUMS) model for 28 d, and drugs were administered at the same time. During the period, rats' behaviors were observed and the blood was collected by using ELISA to determine representative hormone concentrations of HPAA, HPTA and HPGA. The changes in endogenous metabolites were analyzed by using H NMR metabolomics to seek the potential biomarkers. Results showed Fufang Chaigui prescription could improve the behaviors of CUMS rats obviously, increase contents of ACTH, CORT, T₃and decrease contents of TSH and TESTO and regulate the levels of lactate, α-glucose, choline, N-acetylglycoprotein, trimethylamine oxide and leucine to get closer to the contents of control group. The results of correlation analysis indicated that HPTA was associated with glycometabolism, amino acid metabolism and choline metabolism. And HPAA was related to glycometabolism and amino acid metabolism. However, HPGA was only correlated with glycometabolism. In conclusion, Fufang Chaigui prescription could show an obvious anti-depressive effect and its underlying mechanism might involve regulations of neuroendocrine function and pathways of glycometabolism, amino acid metabolism and choline metabolism.
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Animals , Humans , Male , Rats , Antidepressive Agents , Behavior, Animal , Depression , Blood , Drug Therapy , Metabolism , Drugs, Chinese Herbal , Hormones , Metabolism , Metabolomics , Neurosecretory Systems , Metabolism , Rats, Sprague-Dawley , Serum , Chemistry , MetabolismABSTRACT
The anti-depressive effect of Xiaoyaosan is obvious; However, the potential mechanism remains unclear. This paper elucidated the antidepressive mechanism of Xiaoyaosan from the fields of neurotransmitter, neurotrophins, hypothalamic-pituitary- adrenal axis, metabolisms of amino acid, lipid, and energy, inflammatory factor, and metabolic network figure. The comprehensive results implicate that Xiaoyaosan plays as antidepressant via the role of action on multiple targets and regulation in the metabolic balance in vivo.
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<p><b>BACKGROUND</b>Acute hypoxemic respiratory failure (AHRF) often develops acute respiratory distress syndrome (ARDS), and its incidence and mortalities in critically ill pediatric patients in China were 2% and 40% respectively. This study aimed at prospectively investigating incidence, causes, mortality and its risk factors, and any relationship to initial tidal volume (V(T)) levels of mechanical ventilation, in children £5 years of age with AHRF and ARDS.</p><p><b>METHODS</b>In 12 consecutive months in 23 pediatric intensive care units (PICU), AHRF and ARDS were identified in those requiring > 12 hour intratracheal mechanical ventilation and followed up for 90 days or until death or discharge. ARDS was diagnosed according to the American-European Consensus definitions. The mortality and ventilation free days (VFD) were measured as the primary outcome, and major complications, initial disease severity, and burden were measured as the secondary outcome.</p><p><b>RESULTS</b>In 13 491 PICU admissions, there were 439 AHRF, of which 345 (78.6%) developed ARDS, resulting in incidences of 3.3% and 2.6%, and corresponding mortalities of 30.3% and 32.8% respectively along with 8.2 and 6.7 times of relative risk of death in those with pneumonia (62.9%) and sepsis (33.7%) as major underlying diseases respectively. No association was found in V(T) levels during the first 7 days with mortality, nor for V(T) at levels < 6, 6 - 8, 8 - 10, and > 10 ml/kg in the first 3 days with mortality or length of VFD. By binary Logistic regression analyses, higher pediatric risk of mortality score III, higher initial oxygenation index, and age < 1 year were associated with higher mortality or shorter VFD in AHRF.</p><p><b>CONCLUSIONS</b>The incidence and mortalities of AHRF and ARDS in children £5 years were similar to or lower than the previously reported rates (in age up to 15 years), associated with initial disease severity and other confounders, but causal relationship for the initial V(T) levels as the independent factor to the major outcome was not found.</p>
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Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Pneumonia , Epidemiology , Mortality , Respiratory Distress Syndrome , Epidemiology , Mortality , Respiratory Insufficiency , Epidemiology , Mortality , Sepsis , Epidemiology , MortalityABSTRACT
Objective To explore the clinical significances of blood gas and dynamic monitor of respiratory mechanics in respiratory failure children with mechanical ventilation.Methods Sixty-four children who need mechanical ventilation over 24 hours were divided into pulmonary disease group(44 cases) and non-pulmonary disease group(20 cases) in pediatric intensive care unit(PICU),from Jan.2005 to May 2008.By Evita 4 ventilator,dynamic monitor of respiratory mechanics,such as respiratory system compliance(Crs),airway resistance(Raw),mean airway pressue(MAP),minute ventilation(MV),oxgen index(OI),Qs/Qt,respiratory index(RI) and blood gas in these children were determined.Their characteristics and clinical significance were analyzed.Results Many parameters such as Crs,Raw,MAP,MV,Qs/Qt,OI,RI were significantly different between 2 groups(Pa
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Objective To investigate the changes of blood levels of gastrin(GAS),motilin(MTL) and insulinoid growth factor-1(IGF-1) in critical children with multiple organ disfunction syndrome(MODS).Methods The levels of GAS,MTL and IGF-1 in 50 critically ill children and 30 children without critical illness were detected.The control group consisted of 30 health children.All serum or plasma levels of GAS,MTL and IGF-1 were measured by radioimmunoassay.Results The serum or plasma levels of GAS,MTL and IGF-1 were significantly higher in critically ill children than those in uncritically ill children and control group(F=49.61,55.18,18.23 all (P
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Objective To study the life quality of 2 - 3 years old survivors in Neonatal Intensive Care Unit (NICU). Methods Severe neonates were randomly assigned to intervention group (group 1,30 cases) and non- intervention group (group 2,30 cases) depending on the early intervention applied or not,as well as 30 healthy newborns as normal controls. The physical,neurological conditions and intelligence test were taken regularly. To investigate the psychological state, actions, temperament and family conditions when they were2-3 years old.Results Mental development index(MDI) and physical development index(PDI) in early interventional group were significant higher than those in group 2(P