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Plastic bronchitis(PB) is an uncommon respiratory disease characterized by formation of casts in tracheobronchial tree.It can lead to airway obstruction, difficulty of breathing and even respiratory failure.PB in children is commonly associated with lower airway infection, cyanotic congenital heart disease and asthma or atopic diseases.It can also be found in children with sickle cell anemia, thalassemia and cystic fibrosis and so no.There are three main mechanisms for the formation of casts: airway inflammation results in mucus hypersecretion; inflammatory insults lead to necrosis and abscission of the airway epithelium, mucosal edema, and finally cause airway clearance impairment; leakage of chyle from lung lymphatic circulation into airway.But the etiology of this disease is various, pathogenesis is complex.Further research is required to elucidate the pathogenesis.
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Objective To identify the circulating miRNAs which can be used to evaluate the diagnosis and prognosis of sepsis by microarray and quantitative real-time PCR,and to predict target genes of miR-519c-5p by bioinformatics analysis. Methods Three sepsis patients,3 septic shock patients and 3 normal controls were enrolled in this study. Plasma RNA was extracted,and was used for hybridized by miRCURY LNATMmicroRNA Array.The signals were scanned and used to conduct differential expression profilings and cluster analysis.Further-more,we performed qRT-PCR to confirm the expression of miRNAs chosen from microarray screening. We used the miRanda and Targetscan databases to predict target genes of the concerned miRNAs and used KEGG database to analyze the related pathways. Results Fifty-seven and 11 miRNAs were observed significantly upregulated in sepsis and septic shock patients,respectively(fold change≥2.0;P<0.05).qRT-PCR results showed that miR-519c-5p was significantly upregulated in patients with sepsis or patients with septic shock compared with the healthy normal controls(P<0.05).Twenty-nine target genes of miR-519c-5p were predicted by the bioinformatics analysis,and 7 potential target genes participate in the sepsis-related pathways.MiR-519c-5p might be a potential positive regulator for the critical cell cycle control gene of MAP2K4,contributing to the vascular endothelial cells apoptosis via MAPK signaling pathway. Conclusions We demonstrated that the plasma level of miR-519c-5p can be used for the diagnosis of sepsis and miR-519c-5p may be a potential therapeutic target for sepsis.
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Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.
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Objective To analyze the high risk factors of blood infection in Chinese citizens' organ donation,provide the basic evidence for early protection,increase the success rate of donor distribution,and expand the Chinese organ donation pool.Methods A retrospective study was performed on 70 cases of donation recruited during October 2014 to January 2016.The incidence of blood infection in these donors was analyzed.The univariate analysis and multivariate logistic regression analysis were used to find out the high risk factors influencing the donor blood infection.Finally,the donor blood infection assessment model and the receiver operating characteristic (ROC) curve were established to assess the sensitivity and specificity.Results The overall infection rate was 64.3％ (45/70).The pulmonary,blood,and urinary tract infection rate was 42.9％,31.4％ and 1.4％ respectively.The total length of hospital stay (＞10 days) (P =0.017),oxygenation index (＜ 233.5 ± 107.0) (P =0.046),aspartate aminotransferase (＞196.9 ± 329.1 U/L) (P =0.044),and valley alanine aminotransferase (＞95.0 ± 78.1 U/L) (P =0.026) were four risk factors for predicting the donor blood infection.The multivariate logistic regression analysis revealed that the total length of stay ＞10 days along with the donors' oxygenation index (＜233.5 ± 107.0) was independent risk factor for predicting the blood infection.The donor blood infection model was:0.193 + 1.753 hospital stay (＞10 days)-0.007 oxygenation index.The sensitivity and specificity were 0.682 and 0.75 (P ＜0.001) respectively.Conclusion For a long-term stay in ICU,the rate of blood infection for donors was much higher,at this time,the most effective antibiotics should be chosen.Besides,improving donor oxygenation index and liver function can reduce the incidence of infection.
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<p><b>OBJECTIVE</b>Naringenin has been reported to attenuate Mucin (MUC) 5AC secretion in many pathological models. Many stimuli activate MUC5AC expression through JNK/AP-1 signaling pathways. We hypothesized that naringenin may have inhibitory effects on mucous hypersecretion by modulating MUC5AC production and inhibiting JNK/AP-1 signaling pathways.</p><p><b>METHOD</b>The cell model of mucous hypersecretion was made by human lung adenocarcinoma epithelial (A549) cells stimulated by RSV. A549 cells were subcultured and then randomly divided into 7 groups, which were designated as group C (cell control group), groups R1-3 (cells were infected with RSV at the multiplication of infection (MOI) of 0. 5, 1. 0, 5. 0), groups N1-2 (cells infected with viruses in presence of Nar 30 - 100 mol/L), groups N3-4 (uninfected cells treated with Nar 30 - 100 µmol/L), group D (DMSO), group S (cells infected with viruses in presence of SP600125). After incubating for 24 hrs, the expression of MUC5AC at mRNA and protein level in the groups were determined by real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA). The protein expression changes of JNK, p-JNK and AP-1 were measured by Western blotting.</p><p><b>RESULT</b>The expressions of MUC5AC protein and mRNA in all RSV infected groups were significantly higher than that in group C in a dose-dependent manner (all P <0. 05). Nar of 30 and 100 µmol/L significantly and dose-dependently decreased RSV-induced secretion of MUC5AC protein in cell supernatant and expression of MUC5AC mRNA (P <0. 05). The relative content of p-JNK, AP-l in R2 groups were 3. 31 ± 0. 34 and 1. 94 ± 0. 05. Theyfrweremtgnificanty increased as compared with group C (both 1. 00 ± 0. 00) (all P <0. 05). The levels of p-JNK in N2 and S groups were 2. 10 ± 0. 20. 27 and 1.±97 ± 0. 16. The levels of AP-1 in N2 and S groups were 1. 40 ± 0. 03, 1. 36 ± 0. 05. Nar and SP600125 led to a largest decrease in levels of p-JNK and AP-1 when compared with group R2 (P <0. 05). The MUC5AC protein in group R2 was (48. 19 ± 0. 47) µg/L. The protein expression of MUC5AC in group R2 was significantly higher than that in group C [(36. 67 ± 1. 50) g/L] with a statistically significant difference (P <0. 05). The protein expression of MUC5AC in groups N2 and S were(43. 17 ± 1. 06) µg/L, (44.±02 ± 0. 99) µg/L, Nar and SP600125 remarkably inhibited RSV-induced secretion of MUC5AC in supernatant of A549 cells (P < 0. 05).</p><p><b>CONCLUSIONS</b>Naringenin might be able to block RSV-induced mucous</p>
Subject(s)
Humans , Adenocarcinoma , Blotting, Western , Cell Line, Tumor , Enzyme-Linked Immunosorbent Assay , Epithelial Cells , Flavanones , Pharmacology , Lung Neoplasms , Mucin 5AC , Bodily Secretions , Mucus , Bodily Secretions , Random Allocation , Signal Transduction , Transcription Factor AP-1ABSTRACT
Objective To investigate whether myeloid-derived suppressor cells (MDSCs) have a protective effect in septic mice. Methods The model of caecal ligation and puncture (CLP) was performed to induce polymicrobial sepsis in mice. The changes of MDSCs in spleens at different times after operation were studied. In order to observe the influence of MDSCs on the inflammatory factors and survival of septic mice, MDSCs were injected into the peritoneal cavities of mice after CLP. Results MDSCs accumulated in spleens of septic mice progressively. MDSCs could increase anti-inflammatory cytokine production, decrease the level of inflammatory factors, and improve the survival rate of mice with sepsis. Conclusion MDSCs can attenuate the inflammation and improve the survival rate of mice with sepsis, suggesting that intraperitoneal injection of MDSCs may provide a new direction for the treatment of sepsis.
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Objective To determine the prevalence of mortality and respiratory support therapy evolved for severe respiratory failure in pediatric intensive care units(PICU)in China. Method Two sessions of prospective, multicentric, and descriptively epidemiological survey of acute respiratory distress syndrome(ARDS)was carried out in year 2004 and 2006,and survey of alveolar hypoventilation respiratory failure(AHRF)in 2006 by 20 PICUs in China. Data about severity, outcome and respiratory therapy of critically ill patients, as well as PICU facilities were documented prospectively. PICU facilities, patients' mortality and respiratory therapy in different years were compared. Mortality risk factors were analyzed by multivariate logistic regression. Results Compared with those data in year 2004,the number of PICU bed and ventilator increased in year 2006.But,there was no increase in area per bed in year 2006.Proportion of critically ill patients in 2006 was significantly higher than that in 2004(69.0%vs.57.5%,x2=318,P<0.01).There were no significant difference in mortalities of critically ill patients between these two years. According to multivariate regression analysis, mortality was lowered in PICU with increase in heavy working load of physicians, evidenced by linear trend test P=0.013.Mortality of ARDS in year 2006 was significantly lower than that in 2004(39.7%vs 55.8%,x2=6.59,P<0.01).Whereas there was no significant difference in ventilation mode,tidal volume and airway pressure level for ventilated patients between two years.Conclusions With increasing the capacity of PICU there was a significant improvement of treatment as reflected by outcome of ARDS.Mortality of PICU patients was inversely correlated to the working load done by physicians.
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Objective:To summarize the experience in clinical diagno sis of lymphonode reactive hyperplasia (LRH). Methonds: 39 cases with the final pathological diagnosis of lymphonode reactive hyperplasia were retrospectively reviewed.Results: 39 patients had th e incidence at the age of 7～61 years old and the medical history of 14 days ～8 years.The patients consulted doctors because of unilateral or bilateral painles s masses in the superior neck and low fever.32 of them underwent repeated antib iotics treatment.On admission 9 cases were diagnosed with lymphoma,6 tuberculos is,6 inflammation of lymph node and 18 were without identified diagnosis.The f inal pathological diagnoses of all the 39 cases was LRH.Antibiotic treatment wa s effective in the patients.Conclusion:LRH was usually mis diagnosed as other diseases.Swelling of lymph nodes in superior neck with low fe ver is the main symptom of LRH.
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Objective: To investigate the effect of open-mouth jaw plate in the treatment of condylar fracture in children. Method: Open-mouth plates in the height of 2～3 cm were respectively made in op e n-mouth position for 12 children aged 3～6 years old with condylar fractures an d used by the children with the help of doctors or parents for 3～6 months.Follo w -up was carried out by clinical observation and X-ray radiograph.Re sults: Satisfactory results were obtained in all the patients examine d by clinical observation and X-ray radiograph. Conclusion: The method of open-mouth plate is effective in the treatment of condylar f racture in children.
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Objective: To evaluate the effect of concomitant chemoradiotherapy for the prevention of recurrence and metastasis of postoperative salivary adenoid cystic carcinoma(SACC).Methods: 14 cases of salivary adenoid cystic carcinoma after operation were treated with concomitant chemoradiotherapy. Regular radiotherapy of 60 Gy and chemotherapy with hydroxycamptothecin (HCPT) at 10 mg/m 2 , 3 times a week, were administered. HCPT was given in 1st, 2nd, 4th and 5th week. Recurrence and metastasis of SACC after operation were observed using CT, MRI, ultrasonography and X ray. Results: After 3～17 months' follow up, relapse free survival was 100%. No recurrence and metastasis of SACC after operation were found. Adverse reactions of the chemotherapy were nausea, vomiting and leukopenia. After suspended in a short time and using ondansetron and /or G CSF the chemotherapy of HCPT was continued and completed. Conclusion: concomitant chemoradiotherapy of HCPT and radiotherapy can prevent recurrence and metastasis of SACC after operation. The efficacy of long term needs further observation.
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Aim To investigate changes of eosinophil(EOS) and mast cells(MC) in airway of young asthmatic rats and to evaluate of achyranthes bidentata polysaccharides(ABPS) on it.Methods Fifty Sprague-Dawley(SD) rats were randomly divided into five groups,ten rats per group:asthmatic group(A),control group(C),pretreatment groups with ABPS which was done according to three different schedules:consecutively 3 days at sensitization(T_1),at challenge(T_2) or both of the two periods(T_3).Asthmatic rats were induced by intraperitioneal sensitization and challenged with nebulized ovalbumin(OVA).Lungs were embeded in paraffine and sliced,Hematoxylin and eosin(HE) staind tobuidine blue restained and TUNEL method after animals were executed,then the quantity and degranulation phenomenon of EOS and MC and the apoptosis of EOS in airway were observed.Results ① The number of inflammatory cells and EOS in the airway was significantly increased in asthmatic group but reduced in group T_1 and T_3(P
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AIM: To study the effect of signal transducer and activator of transcription 6 (STAT6) on airway inflammation of rats with asthma. METHODS: Male Sprague-Dawley rats were randomly divided into control group and asthma group. The lung tissue was sampled from the left lung. Bronchoalveolar lavage fluid (BALF) was collected from the right lung. The concentrations of IL-4 in serum and BALF were measured by sandwich ELISA. STAT6 protein and STAT6 mRNA were observed in the epithelial cells of bronchus by the technique of immunohistochemistry and in situ hybridization. RESULTS: (1) The concentrations of IL-4 in BALF and serum of asthma group were significantly higher than those in control group (P