ABSTRACT
Objective To evaluate effects of propranolol on the proliferation and apoptosis of in vitro cultured hemangioma endothelial cells (HemEC),and to explore their molecular mechanisms.Methods Hemangioma tissues were resected from 7 children with proliferative hemangioma,and used for in vitro culture of HemEC.Meanwhile,cultured human umbilical vein endothelial cells (HUVEC) served as controls.The 2 kinds of cells were treated with propranolol at different concentrations of 0,25,50,75,100,125 and 150 μmol/L for 24,48 and 72 hours separately.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cellular proliferative activity,and flow cytometry to determine the apoptosis rate.Some cultured HemEC were divided into 2 groups to be treated with 100 μmol/L propranolol-containing culture medium (propranolol group) and culture medium alone (blank control group),respectively,for 18 hours.Total RNA in the 2 groups was extracted separately.Differentially expressed genes in HemEC between the above 2 groups were identified by DNA microarray technology,and verified by real-time quantitative PCR.Results The treatment with 25 μmol/L propranolol for 24 and 48 hours caused a slight proliferation of HemEC (P ＜ 0.05).The survival rate of HemEC was decreased after the treatment with propranolol at the concentration of ≥ 100 μmol/L for more than 24 hours,while the proliferation of HUVEC was inhibited by the treatment with propranolol at the concentration of ≥ 100 μ mol/L for more than 48 hours.During 24-72 hours of treatment with 100-150 μmol/L propranolol,the survival rates of HemEC were significantly lower than those of HUVEC (P ＜ 0.05).After the treatment with 100-150 μmol/L propranolol,the apoptosis rate of HemEC gradually increased with the increase in treatment duration and concentrations of propranolol (all P ＜ 0.05).Compared with the blank control group,186 differentially expressed genes (＞ 1.5-fold changes) were screened out by DNA microarray technology,including 128 upregulated genes and 58 down-regulated genes.Real-time quantitative PCR showed that the mRNA expression of proprotein convertase subtilisin/kexin type 9 (PCSK9) and fatty acid binding protein 3 (FABP3) in the propranolol group were (9.88 ± 2.19) and (21.90 ± 8.18) times that in the blank control group respectively (t =7.028,4.427 respectively,P ＜ 0.05).Conclusions Propranolol at high concentrations can inhibit the proliferation of HemEC and HUVEC,and its inhibitory effect on HemEC is stronger than that on HUVEC.The inhibitory effect of propranolol on HemEC may be related to the inhibition of HemEC proliferation and promotion of HemEC apoptosis.
ABSTRACT
A 10-year and 9-month-old female patient presented with skin rashes all over the body,fever and superficial lymphadenectasis for 18 days after an intravenous drip of fosfomycin.Skin examination showed generalized swollen erythema all over the body,whose surfaces were covered with a large number of sticky furfuraceous grey-white scales.Laboratory examination revealed markedly increased levels of alanine aminotransferase and aspartate aminotransferase,as well as an increased number of eosinophils.Histopathological examination of skin lesions showed infiltration of scattered lymphocytes in the superficial dermis,as well as around skin appendages.Immunohistochemical study demonstrated that the infiltrating lymphocytes mainly included T lymphocytes,and no atypical cells were observed.The patient was diagnosed with druginduced hypersensitivity syndrome.After the treatment with intravenous glucocorticoids,immunoglobulin and oral cyclosporine,favorable therapeutic effects were achieved.
ABSTRACT
Objective To analyze lesional and clinical characteristics of Langerhans cell histiocytosis in children.Methods A clinical retrospective study was performed on 126 patients with Langerhans cell histiocytosis collected from 2006 to 2011 at the Hunan Children's Hospital.Results Of the 126 patients,the youngest was 2months old,and the oldest was 9 years old.The ratio of male to female was 2.5 ∶ 1.Clinical manifestations included eczematid,seborrheic lesions,hemorrhagic maculopapules,yellow nodules and white macules.Of the three clinical phenotypes of Langerhans cell histiocytosis,Letter-Siwe disease was the most prevalent,and most cases of LetterSiwe disease were associated with hepatosplenomegaly,abnormal chest X-ray,impaired hematopoietic function and multifocal bone injuries.The clinical grade was mainly Ⅲ and Ⅳ in patients with Letter-Siwe disease,Ⅰ in patients with eosinophilic granuloma,and varied from Ⅰ to Ⅳ in patients with Hand-Schuller-Christian disease with Ⅱ as the most common.Of these patients,those with eosinophilic granuloma had the oldest average age with bone as the only affected organ,while those with Letter-Siwe disease had the youngest average age with the greatest number of affected organs.The treatment of Langerhans cell histiocytosis included surgical operation and combined chemotherapy.Conclusions Langerhans cell histiocytosis has characteristic skin lesions and diverse clinical manifestations.Pathology has diagnostic significance to Langerhans cell histiocytosis.Therapy strategies and curative effects are dependent on the severity of,and the organs affected by Langerhans cell histiocytosis.
ABSTRACT
Objective To investigate the clinical features of Kawasaki disease.Methods A retrospective analysis was performed in 272 children diagnosed as Kawasaki disease from 2002 to 2006.Clinical data,laboratory findings and auxiliary examination results were collected for these patients.Results The male-to-female ratio Was 2.58:1.Onset ages between 1 to 3 years accounted for 59.2%of patients.Of these patients,100%had a fever for more than 5 days,76.1%transient polymorphous exanthema,74.6% bilateral conjunctival hyperemia,47.8%flare and fissure on the oral lip,58.5%strawberry tongue,22.8% firm swelling of hands and feet as well as flushing of palms and soles,3 1.2%subacute desquamation at the junctional site between nail bed and skin,36%cervical lymphadenopathy.Laboratory findings showed a significant increase in the count of peripheral blood leukocytes and pefipheral blood platelets as well as erythrocyte sedimentation rate in 80.5%,87.5%and 96.2% of Patients,respectively.Additionally,81.6%of these patients were positive for C reactive protein and the frequency of coronary aaery involvement was 54.3%.All patients were treated with aspirin,and high-dose intravenous immunoglobulin was given to 258 patients.Fever relieved and the condition was controlled in all patients with an average hospitalization period of 8.9 days.Conclusions Kawasaki disease should be suspected in Patients with exanthematous lesions,fever lasting for more than 5 days and poor response to antibiotic therapy.Peripheral blood platelet count and cardiac ultrasound are of great value in the diagnosis of Kawasaki disease.Aspirin iS the first choice in treating Kawasaki disease,and adjunctive high-dose intravennous immunoglobulin treatment may facilitate the quick control offever.
ABSTRACT
Objective To investigate the effects of specific immunotheraphy(SIT) using allergens for children atopic dermatitis(AD) to find an efficacious method to treat AD. Methods 148 children with AD were divided into SIT group and control group. All patients were given allergen intradermal tests. The patients in SIT group received SIT using positive aero-allergens for 8 to 18 months. The patients in control group received the treatment of antihistamine drugs and drugs for external use. Results Total effective rate and curative rate of SIT group were 93.2% and 68.9% respectively, and those of control group were 68.9% and 17.6% respectively, which had a significant difference between the two groups(P