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Objective To summarize the clinical characteristics of children with coronary artery aneurysms (CAA) and thrombosis in Kawasaki disease (KD),in order to explore the safe and effective thrombolytic therapy and its prognosis.Methods The clinic,treatment and follow-up data of 210 patients with KD between January 2006 and December 2016 were retrospectively reviewed in the Department of Pediatrics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology.The clinic signs and laboratory data for CAA with thrombosis were analyzed.The characteristics of CAA were monitored by tltrasound.All KD patients with thrombus received intravenous antithrombotic therapy,including urokinase,heparin,and oral Warfarin,and anti-platelet treatment.The effectiveness of antithrombotic treatment was evaluated by measuring the ability to dissolve the thrombus.Results Fourteen cases in 210 patients with KD developed CAA,and had associated thrombosis.In these 14 patients,the largest diameter of CAA was 18.5 mm,and the average value was 12.6 mm.There was no special blood analysis in CAA with thrombus.Moreover,typical KD symptoms and acute myocardial infarction were not found in CAA with thrombosis.Thrombus occurred in giant aneurysms,and 2 patients had multiple thrombosis.After thrombolytic therapy,12 cases in the 14 patients had successful thrombolysis,2 patients had thrombus organization and coronary artery stenosis.Conclusions Neither clinical features nor laboratory data could reliably predict CAA associated thrombosis.Thrombus was easily formed in giant CAA.Frequent and periodly follow-up are important to detect thrombosis in KD patients with giant coronary artery.Therapy with adequate intravenous antithrombotic therapy and anti-platelet treatment earlier can effectively dissolve thrombus in KD patients,and avoid deterioration.
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Objective To study the protective effect of GYY4137 on rat myocardial cells infected by Coxsackie virus B3 (CVB3) and its signal transduction mechanism.Methods Cardiomyocytes were treated with different concentrations of GYY4137(10,50,100 μmol/L) for 24 hours before addition of 100 TCID50 CVB3 for 2 hours before serum-free conditions.After treatment,the cell viability was ascertained with Cell Counting Kit-8 (CCK-8) assay.At the same time,the levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),interleukin-6 (IL-6) in the supernatants were analyzed by enzyme-linked immunosorbent assay (ELISA).Western blot was used to study the expression of nuclear factor kappa-B (NF-κB) protein and the inhibitory subunit of (IκBα) in myocardial cells.Results After exposure of cardiomyocytes to GYY4137 with different concentration (10,50,100 μmol/L)for 24 hours cell viability had no change.The NF-κB expression and the levels of TNF-α,IL-1β,IL-6 [(175.80 ± 5.05) ng/L,(25.80 ± 1.97) ng/L,(65.33 ± 3.51) ng/L] in the GYY4137-treated CVB3 infection group were significantly reduced when compared with untreated CVB3 infection group (P ＜ 0.01),respectively.Compared with the normal group,the GYY4137 concentration-dependently restrained the CVB3-mediated IκBα degradation(P ＜ 0.01).Conclusions GYY4137 exerts anti-inflammatory effects in CVB3-infected cardiomyocytes.This anti-inflammatory mechanism may be associated with suppression of the activation of the NF-κB.
ABSTRACT
The biomarkers associated with coronary artery lesions (CAL) secondary to Kawasaki disease (KD) in Chinese children were investigated by using Meta-analysis. We searched documents published from January 1997 to December 2009 from medical electronic databases. According to inclusion and exclusion criteria, eligible full-text papers were identified. We conducted a comprehensive quantitative analysis by using Stata10.0 statistical software package to assess the heterogeneity among the documents, calculated the summary effect and analyze publication bias and sensitivity. A total of 92 documents and 16 biomarkers were identified. All documents were case-control studies, and included 2398 patients in CAL group and 5932 patients in non-CAL (NCAL) group. The Meta-analysis showed that the levels of platelet count, platelet hematocrit (PCT), neutrophils count, platelet distribution width (PDW), mean platelet volume (MPV), erythrocyte sedimentation rate (ESR), cardiac troponin I (cTnI), and endothelin-1 (ET-1) in CAL group were significantly higher than those in NCAL group, and serum albumin (Alb) and hemoglobin (Hb) levels were significantly lower in CAL group (all P<0.05). White blood cell (WBC) count, serum sodium, matrix metalloproteinase 9 (MMP-9), total cholesterol (TC), hematocrit (HCT) and CD3+T lymphocytes percentage had no statistically significant difference between the two groups. In conclusion, our results indicated that the 10 biomarkers including platelet count, neutrophils count, PCT, PDW, MPV, ESR, cTnI, ET-1, Alb and Hb were associated with CAL, and may be involved in the pathogenesis of CAL. The biomarkers of WBC count, serum sodium, MMP-9, TC, HCT, and CD3+T lymphocytes percentage bore no relationship with the development of CAL among Chinese children with KD.