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Objective:To analyze the clinical manifestations, blood biochemistry indexes, imaging and genetic characteristics of mitochondrial encephalomyopathy with lactic academia and stroke 1ike episodes (MELAS) in children, so as to provide the basis for the diagnosis of MELAS and reduce the misdiagnosis rate.Methods:The clinical data of children with MELAS admitted to the Second Affiliated Hospital of Wenzhou Medical University from January 2000 to December 2020 were retrospectively analyzed, and healthy children undergoing physical examination during the same period were selected as control group.The clinical data were compared between two groups, and the clinical manifestations, blood biochemistry indexes, electrocardiogram, cardiac ultrasound, cranial imaging and genetic testing were analyzed.Results:A total of eight children in MELAS group were collected, including three males and five females.The average age of onset was(9.90±3.89)years.There were eight children in control group, including four boys and four girls, with an average age of(7.92±2.51)years.Among the eight children with MELAS, there were six cases of vomiting, eight cases of epilepsy, five cases of headache, two cases of growth retardation, one case of mental retardation, one case of diabetes, and one case of peripheral neuropathy.The levels of lactate, lactate dehydrogenase, creatine kinase, and pyruvate in MELAS group were higher than those in control group, and the differences were statistically significant( P<0.05). Brain MRI abnormalities were observed in all patients, among which five patients had lesions located in the cerebral cortex, mostly in the parietal occipital temporal lobe, one patient had lesions located in the basal ganglia, and two patients had lesions in both cortex and basal ganglia.MRS of five cases showed inverted lactate peak with bimodal change.The electroencephalogram of eight cases showed slow wave of background activity, and epileptic discharge was observed in two cases.Seven children with MELAS had mtDNA locus mutation M. 3243A>G, and one patient had M. 8344A>G mutation.Eight cases were treated with symptomatic and supportive therapy, and were followed up for 3-5 years, most of them were hospitalized repeatedly because of similar chief complaints.The course of disease was prolonged and repeated, and the symptoms were relieved and discharged after about one week of hospitalization. Conclusion:The clinical manifestations of MELAS in children are diverse, and early diagnosis is difficult.Blood biochemistry, imaging characteristics and genetic testing results are helpful for early diagnosis, early treatment and delaying the progression of the disease.
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Background: Studies have shown that curcumin can regulate the expressions of a variety of miRNAs and affect tumor cell biological behavior. However, whether curcumin affects the biological behavior of gastric cancer cells by regulating expression of miR-539 has not been clarified. Aims: To investigate the effect and mechanism of curcumin on proliferation, migration, invasion, apoptosis of gastric cancer cells by regulating the expression of miR-539. Methods: A total of 49 gastric cancer tissue specimens were collected. Gastric cancer AGS, SGC7901 cells were divided into blank group, curcumin group, negative control group, miR-539 mimics group, miR-539 inhibitor group, inhibitor control group, miR-539 inhibitor +curcumin group. qRT-PCR was used to detect the mRNA expression of miR-539 in gastric cancer tissue and cells. Cell proliferation was detected by MTT. Scratch test, Transwell test were used to detected cell migration and invasion. Cell apoptosis was determined by flow cytometry. Western blotting was used to detect protein expressions of APOBEC3B, c-Myc, cyclin D1, claudin-1 and N-cadherin. Results: Expressions of miR-539 mRNA in gastric cancer tissue and gastric cancer cells were significantly decreased than those in corresponding controls (P<0.05), and was related to tumor stage in gastric cancer patients (P<0.05). Curcumin up-regulated the expression of miR-539 mRNA in a dose-dependent manner (P<0.05). Compared with corresponding control group, cell proliferation, migration and invasion were significantly decreased in miR-539 mimics group and curcumin group (P<0.05), cell apoptosis rate was significantly increased (P<0.05), and protein expressions of APOBEC3B, c-Myc, cyclin D1, claudin-1 and N-cadherin were significantly decreased (P<0.05). Conclusions: Expression of miR-539 is decreased in gastric cancer, and curcumin can inhibit proliferation, migration and invasion of gastric cancer cells and induce cell apoptosis by up-regulating the expression of miR-539.
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Objective To evaluate the correlation between the gray-white matter ratio (GWR) and the outcomes of comatose adult survivors from cardiac arrest (CA) in Chinese.Methods Sixty-one CA patients checked with CT scans within 72 hours of resuscitation from January 2011 to January 2016 were included in this single-center retrospective study.Gray and white matter density (Hounsfield units) were measured,and the GWRs were calculated according to previous studies.The prognostic values of the GWRs in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed.Results The density values of gray matter were significantly higher in the good outcome group than those in the poor one.All GWRs were significantly higher in the good outcome group (P ＜ 0.05).A GWR (basal ganglia) ＜ 1.18 predicted poor outcomes with a sensitivity and specificity of 50.0％ and 88.2％,respectively (P =0.012).Conclusions Low GWRs,determined from brain CT scans in comatose CA patients after resuscitation,were associated with poor neurological outcomes.GWR determination from brain CT can be a useful indicator for outcome prediction aiding in an optimal clinical decision process in comatose survivors from CA.