A pilot study on the effects of early use of valproate sodium on neuroinflammation after traumatic brain injury / 中国当代儿科杂志

OBJECTIVES@#To study the effect of early use of sodium valproate on neuroinflammation after traumatic brain injury (TBI).@*METHODS@#A total of 45 children who visited in Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from August 2021 to August 2022 were enrolled in this prospective study, among whom 15 healthy children served as the healthy control group, and 30 children with TBI were divided into a sodium valproate treatment group and a conventional treatment group using a random number table (n=15 each). The children in the sodium valproate treatment group were given sodium valproate in addition to conventional treatment, and those in the conventional group were given an equal volume of 5% glucose solution in addition to conventional treatment. The serum concentrations of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3), high-mobility group box 1 (HMGB1), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were measured in the healthy control group on the day of physical examination and in the children with TBI on days 1, 3, and 5 after admission. Glasgow Outcome Scale-Extended (GOS-E) score was evaluated for the children with TBI 2 months after discharge.@*RESULTS@#Compared with the healthy control group, the children with TBI had significantly higher serum concentrations of NLRP3, HMGB1, TNF-α, and IL-1β on day 1 after admission (P<0.017). The concentration of NLRP3 on day 5 after admission was significantly higher than that on days 1 and 3 after admission in the children with TBI (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of NLRP3 than the conventional treatment group (P<0.05). For the conventional treatment group, there was no significant difference in the concentration of HMGB1 on days 1, 3, and 5 after admission (P>0.017), while for the sodium valproate treatment group, the concentration of HMGB1 on day 5 after admission was significantly lower than that on days 1 and 3 after admission (P<0.017). On day 5 after admission, the sodium valproate treatment group had a significantly lower concentration of HMGB1 than the conventional treatment group (P<0.05). For the children with TBI, the concentration of TNF-α on day 1 after admission was significantly lower than that on days 3 and 5 after admission (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of TNF-α than the conventional treatment group (P<0.05). The concentration of IL-1β on day 3 after admission was significantly lower than that on days 1 and 5 after admission (P<0.017) in the children with TBI. On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of IL-1β than the conventional treatment group (P<0.05). The GOS-E score was significantly higher in the sodium valproate treatment group than that in the conventional treatment group 2 months after discharge (P<0.05).@*CONCLUSIONS@#Early use of sodium valproate can reduce the release of neuroinflammatory factors and improve the prognosis of children with TBI.

Risk factors for massive blood transfusion in pediatric living donor liver transplantation / 中华麻醉学杂志

Objective:To identify the risk factors for massive blood transfusion in pediatric living donor liver transplantation.Methods:The medical data of children underwent living donor liver transplantation in our hospital from April 2006 to April 2019 were retrospectively collected.Massive transfusion was defined as the administration of red blood cells > 1 fold of the total blood volume (70 ml/kg) during operation.Patients were assigned to massive transfusion group and non-massive transfusion group according to the volume of blood transfused during operation.Binary logistic regression analysis was used to identify the risk factors for massive blood transfusion during living liver transplantation.Results:A total of 95 pediatric patients were enrolled in this study, with 18 cases in massive transfusion group and 77 cases in non-massive transfusion group.The incidence of massive blood transfusion was 19% during operation.The results of logistic regression analysis showed that preoperative survival status of " hospitalization" ( OR=49.816, 95% CI 2.945-842.59, P=0.007), increased serum Cr concentrations ( OR=1.046, 95% CI 1.007-1.086, P=0.021), increased Pediatric End-Stage Liver Disease (PELD) or Model for End-Stage Liver Disease (MELD) score ( OR=1.215, 95% CI 1.046-1.411, P=0.011) and prolonged operation time( OR=1.623, 95% CI 1.133-2.327, P=0.008) were the independent risk factors for intraoperative massive blood transfusion in living donor liver transplantation, while increased recipient weight ( OR=0.856, 95% CI 0.761-0.962, P=0.009) was a protective factor for intraoperative massive blood transfusion. Conclusions:Preoperative survival status of " hospitalization", increased PELD or MELD score and prolonged operation time are independent risk factors, while increased pediatric weight is a protective factor for massive blood transfusion in pediatric living donor liver transplantation.

Effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To study the effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen.@*METHODS@#A total of 102 children with acute abdomen who underwent surgery in Xuzhou Children's Hospital from August 2019 to June 2021 were enrolled as subjects and were randomly divided into an observation group and a control group, with 51 children in each group. The children in the control group were given conventional treatment such as hemostasis and anti-infective therapy after surgery, and those in the observation group were given somatostatin in addition to conventional treatment. Peripheral blood samples were collected from both groups before surgery and on days 1 and 5 after surgery. The two groups were compared in terms of the serum levels of endothelin-1 (ET-1), adrenocorticotropic hormone (ACTH), cortisol, gastrin, and motilin, postoperative recovery, and the incidence rate of complications.@*RESULTS@#There was no significant difference in the serum levels of ET-1, ACTH, cortisol, gastrin, and motilin between the two groups before surgery (P>0.05). Compared with the control group, the observation group had significantly lower serum levels of ET-1, ACTH, and cortisol on days 1 and 5 after surgery (P<0.05) and significantly higher levels of motilin and gastrin on day 5 after surgery (P<0.05). Compared with the control group, the observation group had significantly shorter time to first passage of flatus, first bowel sounds, and first defecation after surgery, as well as a significantly shorter length of hospital stay (P<0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group (6% vs 24%, P<0.05).@*CONCLUSIONS@#In children with acute abdomen, somatostatin can significantly reduce postoperative stress response, improve gastrointestinal function, and reduce the incidence rate of complications, thereby helping to achieve a good prognosis.

Latent class analysis of symptom characteristics in young and middle-aged peritoneal dialysis patients / 中国实用护理杂志

Objective:To classify the symptom characteristics of young and middle-aged peritoneal dialysis patients and to explore the differences of demographic functional status and social function of patients with different symptom categories.Methods:A total of 179 peritoneal dialysis patients from 3 peritoneal dialysis centers in Shanghai were investigated from December 2019 to August 2020 by General Information Questionnaire, Peritoneal Dialysis Symptom Distress Scale. Latent class analysis was used to classify young and middle-aged peritoneal dialysis patients according to symptom characteristics. Multiple Logistic regression was used to explore the differences of demographic and disease characteristics of different categories of patients.Results:Peritoneal dialysis patients could be divided into three potential categories according to symptom characteristics ( P<0.05). According to the conditional probability of each category, they were named "low symptom group" (111 cases,62.0%), "high psychological-moderate physical symptom group" (22 cases, 12.3%), "high symptom group" (46 cases,25.7%). There were differences in working status ( OR=0.029, P<0.01), education level ( OR=152.799, P<0.01), duration ( OR=81.307, P<0.05), diabetic nephropathy ( OR=80.619, P<0.01) and CCI score ( OR=91.188, P<0.01) distribution among different potential categories of young and middle-aged peritoneal dialysis patients. Conclusions:There are three types of potential symptoms in young and middle-aged patients undergoing peritoneal dialysis. In clinical practice, medical staff should focus on the psychological status of young and middle-aged patients with low educational background and early stage of dialysis, and encourage them to return to work; at the same time, they should regularly evaluate the symptom burden of patients with diabetic nephropathy and high complication index peritoneal dialysis patients, in order to provide targeted intervention measures to prevent the progression of the disease.

Transcriptome Sequencing Reveals the Potential Mechanisms of Modified Electroconvulsive Therapy in Schizophrenia

Objective@#Schizophrenia (SCZ) is one of the most common and severe mental disorders. Modified electroconvulsive therapy (MECT) is the most effective therapy for all kinds of SCZ, and the underlying molecular mechanism remains unclear. This study is aim to detect the molecule mechanism by constructing the transcriptome dataset from SCZ patients treated with MECT and health controls (HCs). @*Methods@#Transcriptome sequencing was performed on blood samples of 8 SCZ (BECT: before MECT; AECT: after MECT) and 8 HCs, weighted gene co-expression network analysis (WGCNA) was used to cluster the different expression genes, enrichment and protein-protein interaction (PPI) enrichment analysis were used to detect the related pathways. @*Results@#Three gene modules (black, blue and turquoise) were significantly associated with MECT, enrichment analysis found that the long-term potentiation pathway was associated with MECT. PPI enrichment p-value of black, blue, turquoise module are 0.00127, <1×10-16 and 1.09×10-13, respectively. At the same time, EP300 is a key node in the PPI for genes in black module, which got from the transcriptome sequencing data. @*Conclusion@#It is suggested that the long-term potentiation pathways were associated with biological mechanism of MECT.

Transcriptome Sequencing Reveals the Potential Mechanisms of Modified Electroconvulsive Therapy in Schizophrenia

Objective@#Schizophrenia (SCZ) is one of the most common and severe mental disorders. Modified electroconvulsive therapy (MECT) is the most effective therapy for all kinds of SCZ, and the underlying molecular mechanism remains unclear. This study is aim to detect the molecule mechanism by constructing the transcriptome dataset from SCZ patients treated with MECT and health controls (HCs). @*Methods@#Transcriptome sequencing was performed on blood samples of 8 SCZ (BECT: before MECT; AECT: after MECT) and 8 HCs, weighted gene co-expression network analysis (WGCNA) was used to cluster the different expression genes, enrichment and protein-protein interaction (PPI) enrichment analysis were used to detect the related pathways. @*Results@#Three gene modules (black, blue and turquoise) were significantly associated with MECT, enrichment analysis found that the long-term potentiation pathway was associated with MECT. PPI enrichment p-value of black, blue, turquoise module are 0.00127, <1×10-16 and 1.09×10-13, respectively. At the same time, EP300 is a key node in the PPI for genes in black module, which got from the transcriptome sequencing data. @*Conclusion@#It is suggested that the long-term potentiation pathways were associated with biological mechanism of MECT.

Effect and mechanism of DL-3-n-butylphthalide on emotional memory in mice with chronic alcoholism / 中华行为医学与脑科学杂志

Objective:To investigate the improvement and possible mechanism of dl-3-n-butylphthalide (NBP) on the emotional memory of chronic alcoholism model mice.Methods:Twenty-four adult male C57/BL6 mice were randomly divided into control group (CON, n=8), model group (AT, n=8), treatment group (AT+ NBP, n=8). Mice in AT group and AT+ NBP group were administrated with alcohol to establish chronic alcoholism model. In the AT+ NBP group, the mice was administrated with NBP (40 mg/kg) by gavage once a day for 14 days during the alcohol modeling period. Ang the mice in AT group and CON group was given the same dose of corn oil by gavage.Open field test was used to evaluate anxiety-like behavior, tail suspension test to evaluate depression-like behavior, Morris water maze and new object recognition to evaluate memory ability, and TUNEL staining to evaluate the number of neuron apoptosis. The primary cultured neurons were interfered by alcohol and NBP at the cell level, and the calcium concentration in the neurons was detected by fluorescence calcium imaging. Descriptive analysis, t-test and one-way ANOVA were processed by SPSS 17.0. Results:The results of open field test showed that the exploration time of AT+ NBP group was longer than that of AT group ((50.68±7.82)s, (38.50±13.93)s; t=-2.16, P<0.05)). In the spatial memory test, the target quadrant exploration time of AT+ NBP group was longer than that of AT group ((28.02±7.13)s, (20.98±5.58)s; t=-2.20, P<0.05). In short memory test, the cognitive coefficient RI (0.83±0.08) of AT+ NBP group was higher than that of AT group (0.68±0.10) ( t=-3.13, P<0.05). Compared with CON group, the number of neuron apoptosis in prefrontal cortex in AT group increased ((17.33±2.51), (115.67±6.50); t=-24.41, P<0.001), and that in AT+ NBP group decreased compared with AT group((45.00±5.57)) ( t=14.29, P<0.001). The number of apoptosis neurons in the dentate gyrus of the hippocampus in AT group (13.75±4.79) was also less than that in the AT+ NBP group (5.75±3.30) ( t=2.75, P<0.05). Calcium concentration in nerve cells was detected that the three concentrations of alcohol (100 mmol/L, 200 mmol/L and 300 mmol/L) led to a significant increase in the RFU within the nerve cells (△F/F) ((1.43±0.32), (2.31±1.39), (1.21±0.73); t=-7.67, -2.85, -2.86, all P<0.05). In comparison, the changes of RFU in the three groups treated with NBP treatment were relatively stable ((0.04±0.01), (-0.03±0.01), (-0.04±0.02); t=7.96, 2.96, 2.92, all P< 0.05). Conclusion:The 3-n-Butylphthalide can improve the learning and memory ability of chronic alcoholism model mice, which may be related with the inhibition of neuron apoptosis and the influence of intracellular calcium homeostasis.

Effect of autonomous motivation on the severity and short-term clinical effcacy of depression / 中华行为医学与脑科学杂志

Objective To investigate the traits of autonomous motivation and its effect on the de-pression severity and short-term clinic outcome. Methods Behavioral Approach System and Behavioral In-hibition System Scale(BAS / BIS),Motivational Traits Questionnaire Short Form(MTQ),the Hamilton De-pression Scale(HAMD-17)and the Hamilton Anxiety Scale(HAMA)were applied to 82 depression patients (case group)at baseline and after 2 weeks of treatment and 82 gender-matched healthy controls(control group). The reduction rate of HAMD total scores before and after treatment was used as the main efficacy in-dicator.Results The scores of MTQ-desire to learn((30.37 ± 6.78)vs(33.72 ± 4.34))and MTQ-mastery ((28.68±6.24)vs(32.29±4.74)),BAS-drive scores((9.90±2.76)vs(11.18±2.13))were significantly lower in the case group than those in the control group,and the difference was statistically significant(all P<0.001),While the scores of MTQ-emotionality((36.26± 7.14)vs(27.29± 5.73)),MTQ-worry((40.87± 7.56)vs(33.69±6.38)),BIS scores((22.68±2.61)vs(15.51±3.62))were significantly higher than those in the control group,the difference was statistically significant(all P<0.01).Correlation analysis found that baseline HAMD-17total scores were significantly positively correlated with baseline HAMA total scores(r=0.666,P<0.05),BIS(r=0.278,P<0.05),MTQ-worry(r=0.264,P<0.05)and MTQ- emotionality(r=0.371, P<0.05). Baseline HAMA total scores were significantly positively correlated with baseline HAMD-17 total scores(r=0.666,P<0.05),MTQ-worry(r=0.228,P<0.05)and MTQ-emotionality(r=0.282,P<0.05). The reduction rate of HAMD-17 and HAMA in patients with 2 weeks of treatment was respectively used with step-wise regression analysis,which showed that the significant contribution of MTQ-mastery and BAS-drive,and explained the reduction rate variables 19%(R2=0.19)of HAMD. BAS-drive contributed significantly,and explained the reduction rate variables 16.9%(R2=0.169)of HAMA. Conclusion Autonomous motivation levels of depression patients are significantly lower than that of healthy controls,while higher levels of autono-mous motivation(BAS-drive)may be associated with better short-term clinic outcome.

Clinical observation of modified frontalis tendon flap suspension in the treatment of severe congenital blepharoptosis in children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the long-term clinical effect of modified frontalis tendon flap suspension in the treatment of severe blepharoptosis in children.METHODS:A total of 83 cases (114 eyes) of modified frontalis tendon flap suspension for children severe blepharoptosis correction were analyzed between January 2009 to December 2011 for the efficacy and complications of this surgery.Follow-up observation for 5a.RESULTS:In the fifth year after operation,there were 84 eyes (73.7％) with correction and satisfactory correction,30 eyes (26.3％) were corrected,and the operation was satisfactory.Postoperative complications included 4 eyes (3.5％) of inverted eyelashes,of which 3 eyes were given suture traction at 1/3 interior of the gray line,1wk later inverted eyelashes disappeared,1 eye of secondary surgery.Conjunctival prolapse was in 2 eyes (1.8％),the application of corticosteroids eye drops,pressure bandage were used for 1 wk and conjunctival prolapse disappeared.There was no recurrence of keratitis,eyelid ectropion,septum separation,eyelid angular deformity,hematoma formation,infection and other complications.Postoperative retrograde retrogression and lateral eyelid folds disappear were the most common problems of long-term follow-up.CONCLUSION:The study shows that this surgical technique is a satisfied method to treat severe blepharoptosis and predictable with few complications.

Value of preoperative MRI technology in diagnosing pituitary cystic lesions / 局解手术学杂志

Objective To explore the value of MRI technology in diagnosing pituitary cystic lesions,and to improve the diagnostic level of MRI imaging of pituitary cystic lesions. Methods Retrospective analysis of the MRI examination data of 31 cases with pituitary cystic le-sions confirmed pathologically from January 2013 to November 2016, including cystic pituitary tumor 16 cases,pituitary abscess 6 cases and Rathke' s cyst 9 cases,all the cases underwent MRI scan and 22 underwent enhanced GD-DTPA scan. Results 16 cases of cystic pituitary tumor,12 cases of large pituitary adenomas, micro adenoma 4 cases. 12 cases large pituitary adenomas were shown as in solid tumors in the capsule,T1WI showed low signal,while T2WI showed high signal. Capsule wall was equal signal and thickness was uneven,obvious enhance-ment,3 cases with bleeding,T1WI showed high signal,and liquid level. 4 cases of cystic adenoma,TIWI showed slightly low signal,T2WI showed high signal,edge mild enhancement,1 case had been preoperatively misdiagnosed as Rathke' s cyst,1 case of missed diagnosis. 6 ca-ses of pituitary abscess,T1WI was low or equal signal,T2WI was equal, high signals or uneven,most of the boundary was not clear,Most of the lesions in circular reinforcement or separated reinforcement,uneven parts for reinforcement,Visible near the base of skull meningeal,cav-ernous sinus area reinforcement. 2 cases of T2WI of mixed high and low signal,preoperative misdiagnosed as pituitary tumors and tumor apo-plexy. 9 cases of Rathke's cyst,5 cases were shown as slightly long T1 long T2 signal, boundary was clear,the edges slightly enhanced,4 ca-ses in T1WI,T2WI high signal,among them 2 cases misdiagnosed as craniopharyngioma. The diagnostic accuracy rates were respectively:87. 5％, 66. 7％, 77. 8％. Conclusion MRI can well show the location,shape and signal characteristics of pituitary cystic lesions in the sellar region,and can make qualitative diagnosis to a large extent,which is of guiding significance for clinical operation.

α2-macroglobulin alleviates X-ray induced obstacle on osteogenic differen-tiation of human bone marrow mesenchymal stem cells / 中国病理生理杂志

AIM:To evaluate the effect of α2-macroglobulin(α2M) against X-ray induced obstacle on osteo-genic differentiation of human bone marrow mesenchymal stem cells(hBMMSCs). METHODS:hBMMSCs were cultured in vitro. The 4th generation of hBMMSCs was irradiated with 8 Gy X-ray,then induced osteogenic differentiation and trea-ted with different concentrations of α2M(0.5 and 1.0 g/L). The alkaline phosphatase(ALP) activity and the mRNA ex-pression of runt-related transcription factor-2 (RUNX2) were detected on day 7 after osteogenic induction. The protein ex-pression of osteoglycin (OGN) was evaluated by Western blot on day 14 after osteogenic induction. The formation of calci-um nodules was detected by alizarin red staining on day 21 after osteogenic induction. The activity of superoxide dismutase (SOD) and the protein expression of MnSOD of irradiated hBMMSCs with 8 Gy X-ray were determined at 24 h after α2M treatment. RESULTS:Compared with 8 Gy X-ray group,the activity of ALP,the mRNA expression of RUNX2,the pro-tein expression of OGN and MnSOD,as well as SOD activity were higher than those in the hBMMSCs treated with α2M at 0.5 and 1.0 g/L after 8 Gy X-ray irradiation,and the calcium nodules were also increased. CONCLUSION:α2M signifi-cantly improves the osteogenic differentiation ability,the SOD activity and MnSOD protein expression of hBMMSCs after ra-diation injury.

Therapeutic effect and white matter integrity of low frequency repetitive transcranial magnetic stimulation and the modified electric convulsive therapy in patients with schizophrenia / 实用医学杂志

Objective To investigate the efficacy and white matter integrity of low frequency repetitive transcranial magnetic stimulation (rTMS) and the modified electroconvulsive therapy (MECT) in patients with schizophrenia. Methods From May 2015 to October 2016,120 cases with schizophrenia were randomly enrolled into the MECT group and of the rTMS group. Patients in the MECT group were treated with the modified electric convulsive therapy for 8 times ,while patients in the rTMS group were treated with the repetitive transcranial magnetic stimulation for 12 times. PANSS were used to evalue the clinical effects. Repeatable battery for the assess-ment of neuropsychological status was used to assess the cognitive function. Treatment emergent side-effect scale was used to assess the adverse effects. Brain fractional anisotropy was used to assess white matter integrity. Results After treatment,the PANSS scores were significantly lowered,however,the RBANS scores were signifi-cantly higher in the MECT group and rTMS group than those before treatment ,with significant differences (P <0.05). No significant differences for the PANSS scores and the RBANS scores were observed between the two groups before and after treatment. There was no significant difference for the TESS scores between the two groups before treatment(P > 0.05). After treatment,the TESS scores in the MECT group were significantly higher than those in the rTMS group(P < 0.05). After treatment,the FA values of left anterior cingulate gyrus,left posterior cingulate gyrus ,left prefrontal cortex and genu of corpus callosum for both MECT group and rTMS group were significantly increased (P < 0.05 ,respectively). Compared with the MECT group ,the FA value significantly increased in the rTMS group after treatment (P < 0.05). Conclusions Both MECT and rTMS have significant clinical efficacies and can improve the cognitive function of schizophrenics. rTMS is more safe than MECT ,with a stronger effect on preventing the integrity of white matter than MECT.

Two kinds of detection methods of antinuclear antibodies in diagnosis of systemic lupus erythematosus / 实用医学杂志

Objective To detect serum antinuclear antibody (ANA) with enzyme-linked immunosorbent (ELISA) and linear immunoblot technique (LIA) and to evaluate and compare the performance of two methods in auxiliary diagnosis of systemic lupus erythematosus (SLE). Methods ANA detected by both ELISA and LIA of 597 cases were collected in the last two years. The results were retrospective analyzed. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and the consistency of the two methods were compared and analyzed. Results The sensitivity of ELISA and LIA was 79.3% and 86.6% respectively for SLE patients; specificity 81.7% and 77.3%; accuracy 81.4% and 78.6%, positive predictive value 40.9%, and 37.8%;negative predictive value 96.1% and 97.3% respectively. No significant difference was found between the two methods (P > 0.05). The results showed that the coincidence rate was 81.4%, and the Kappa test 0.55. The Kappa test of the two methods in SLE group was 0.403. Conclusion No statistical significance is found in the comparison of ELISA method and LIA method to detect ANA for the diagnosis of SLE and the combination of two kinds of detection method has important application value.

Genomic level analysis of the molecular resistance mechanism for Pseudomonas aeruginosa PA902 / 实用医学杂志

Objective To investigate the resistance mechanism of Pseudomonas aeruginosa PA902 by high -throughput sequencing.Method PA902 was sequenced by the Illumina Miseq platform,and sequencing data were analyzed by bioinformatic techniques.Results PA902 was resistant to all common clinical antibiotics except amikacin.Analysis of data reveal resistance genes to β-1actams (blaOXA-10,blaPER-1 和 blaVIM-2),aminoglycosides (aph (3 ‘)-Ⅱd,aac (6')-Ⅰb-cr,aacA4 和 aadA2),sulfonamides (sul1),tetracyclines (tetG),chloramphenicol (floR).Several putative chromosome-located resistance genes were also identified.The results were fully in accordancc with thc susceptibility results.Sequence analysis of the contigs containing resistance genes revealed that they were always clustered on the same contig and correlated mobilization sequences.MLST identified PA902 as ST389,which was first reported in China.Conclusion High throughput sequencing demonstrated the molecular resistance mechanism of PA902,and the findings were in accordance with the susceptibility results.The technique will provide solid support for the traditional clinical microbiology methods.

Role of T?SPOT.TB test in diagnosis of active tuberculosis / 实用医学杂志

Objective To assess the value of T?SPOT.TB test in the diagnosis of active tuberculosis. Methods The clinical data of 975 hospitalized patients receiving T?SPOT.TB test were collected in our hospital. The clinical information and testing results were analyzed. The receiver operating curve (ROC) was used to determine the optimal threshold of T?SPOT.TB test for differentiating active tuberculosis. Results T?SPOT.TB test results showed that the positive rate was 29.26%for the non?active tuberculosis group(n=793),but was 91.21%for active tuberculosis patients group (n = 182),which indicated that the test had a significant value in active tuberculosis detection(P<0.001). The sensitivity of T?SPOT.TB test was 0.912 and the specificity was 0.707. The detection threshold of T?SPOT.TB was optimized. As the spot?forming count(sfc)of ESAT?6 antigen threshold was 11.5 and that of the CEP?10 threshold was 9.5,the efficiency of T?SPOT.TB test for detection of active pulmonary tuberculosis was the highest. Conclusions T?SPOT.TB test has a good diagnostic performance for active tuberculosis, and it can be further optimized to better serve the clinical practice.

Exploration of common biological pathways for attention deficit hyperactivity disorder and low birth weight / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore common biological pathways for attention deficit hyperactivity disorder (ADHD) and low birth weight (LBW).</p><p><b>METHODS</b>Thei-Gsea4GwasV2 software was used to analyze the result of genome-wide association analysis (GWAS) for LBW (pathways were derived from Reactome), and nominally significant (P< 0.05, FDR< 0.25) pathways were tested for replication in ADHD.Significant pathways were analyzed with DAPPLE and Reatome FI software to identify genes involved in such pathways, with each cluster enriched with the gene ontology (GO). The Centiscape2.0 software was used to calculate the degree of genetic networks and the betweenness value to explore the core node (gene). Weighed gene co-expression network analysis (WGCNA) was then used to explore the co-expression of genes in these pathways.With gene expression data derived from BrainSpan, GO enrichment was carried out for each gene module.</p><p><b>RESULTS</b>Eleven significant biological pathways was identified in association with LBW, among which two (Selenoamino acid metabolism and Diseases associated with glycosaminoglycan metabolism) were replicated during subsequent ADHD analysis. Network analysis of 130 genes in these pathways revealed that some of the sub-networksare related with morphology of cerebellum, development of hippocampus, and plasticity of synaptic structure. Upon co-expression network analysis, 120 genes passed the quality control and were found to express in 3 gene modules. These modules are mainly related to the regulation of synaptic structure and activity regulation.</p><p><b>CONCLUSION</b>ADHD and LBW share some biological regulation processes. Anomalies of such proces sesmay predispose to ADHD.</p>

Therapeutic effect and white matter integrity of low frequency repetitive transcranial magnetic stimulation and the modified electric convulsive therapy in patients with schizophrenia / 实用医学杂志

Objective To investigate the efficacy and white matter integrity of low frequency repetitive transcranial magnetic stimulation (rTMS) and the modified electroconvulsive therapy (MECT) in patients with schizophrenia. Methods From May 2015 to October 2016,120 cases with schizophrenia were randomly enrolled into the MECT group and of the rTMS group. Patients in the MECT group were treated with the modified electric convulsive therapy for 8 times ,while patients in the rTMS group were treated with the repetitive transcranial magnetic stimulation for 12 times. PANSS were used to evalue the clinical effects. Repeatable battery for the assess-ment of neuropsychological status was used to assess the cognitive function. Treatment emergent side-effect scale was used to assess the adverse effects. Brain fractional anisotropy was used to assess white matter integrity. Results After treatment,the PANSS scores were significantly lowered,however,the RBANS scores were signifi-cantly higher in the MECT group and rTMS group than those before treatment ,with significant differences (P <0.05). No significant differences for the PANSS scores and the RBANS scores were observed between the two groups before and after treatment. There was no significant difference for the TESS scores between the two groups before treatment(P > 0.05). After treatment,the TESS scores in the MECT group were significantly higher than those in the rTMS group(P < 0.05). After treatment,the FA values of left anterior cingulate gyrus,left posterior cingulate gyrus ,left prefrontal cortex and genu of corpus callosum for both MECT group and rTMS group were significantly increased (P < 0.05 ,respectively). Compared with the MECT group ,the FA value significantly increased in the rTMS group after treatment (P < 0.05). Conclusions Both MECT and rTMS have significant clinical efficacies and can improve the cognitive function of schizophrenics. rTMS is more safe than MECT ,with a stronger effect on preventing the integrity of white matter than MECT.

Application of esmolol in severe hand, foot, and mouth disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical effect and mechanism of action of esmolol in the treatment of severe hand, foot, and mouth disease (HFMD).</p><p><b>METHODS</b>A prospective randomized controlled trial was performed. A total of 102 children with severe HFMD were enrolled in the study and were randomly divided into conventional treatment and esmolol treatment groups (n=51 each). The children in the conventional treatment group were given conventional treatment according to the guidelines for the diagnosis and treatment of HFMD. Those in the esmolol treatment group were given esmolol in addition to the conventional treatment. The heart rate (HR), systolic blood pressure (SBP), and respiratory rate (RR) were continuously monitored for all children. Blood samples were collected from all children before treatment and 1, 3, and 5 days after treatment to measure the levels of norepinephrine (NE), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and nuclear factor-kappa B (NF-κB) p65 in mononuclear cells. Serum levels of myocardial enzymes and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured before treatment and after 5 days of treatment.</p><p><b>RESULTS</b>There were no significant differences in HR, SBP, RR, NE, TNF-α, IL-6, NF-κB p65, serum myocardial enzymes, and NT-proBNP before treatment between the conventional treatment and esmolol treatment groups. Both groups had significant reductions in these parameters at each time point (P<0.05). Compared with the conventional treatment group, the esmolol treatment group had significant improvements in the above parameters after 1 and 3 days of treatment (P<0.05). After 5 days of treatment, the esmolol treatment group had significant improvements in serum levels of myocardial enzymes and NT-proBNP compared with the conventional treatment group (P<0.05).</p><p><b>CONCLUSIONS</b>Early application of esmolol can effectively stabilize the vital signs of the children with severe HFMD. Its mechanism of action may be related to reducing serum catecholamine concentration, alleviating myocardial damage, improving cardiac function, and reducing inflammatory response.</p>

Clinical effect and safety of somatostatin in treatment of postoperative gastrointestinal bleeding in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect and safety of somatostatin in the treatment of postoperative gastrointestinal bleeding in neonates.</p><p><b>METHODS</b>A prospective randomized study was performed, and 126 neonates who underwent surgery for congenital gastrointestinal anomalies were randomly divided into control group, treatment group A, and treatment group B. The neonates in the control group were given routine postoperative hemostasis, and those in the treatment groups were given somatostatin in addition to the treatment for the control group. The neonates in treatment group A were given intravenous injection of somatostatin 0.25 mg as the initial dose and 0.25 mg/h for maintenance, and those in treatment group B were given continuous intravenous pumping of somatostatin at a dose of 3.5 μg/(kg·h). The clinical outcome and complications were compared between the three groups.</p><p><b>RESULTS</b>Compared with the control group, the treatment groups had significantly shortened clearance time in occult blood test for gastrointestinal decompression drainage and a significantly lower degree of the reduction in 24-hour hemoglobin (P<0.05), while there were no significant differences between treatment groups A and B. Compared with the control group, treatment group A had significant reductions in heart rate (HR), respiratory rate (RR), blood pressure (BP), and SaO2 after one hour of treatment (P<0.05 ), but there were no significant differences at the other time points between the two groups (P>0.05). There were no significant differences in monitoring indices between the control group and treatment group B (P>0.05). No neonates in the control group experienced hypoglycemia reaction, and treatment group A had a significantly higher incidence rate of hypoglycemia (20%) than treatment group B (P<0.05).</p><p><b>CONCLUSIONS</b>Somatostatin has a marked clinical effect and good safety in the treatment of neonates with postoperative gastrointestinal bleeding, and the administration of somatostatin by continuous intravenous pumping leads to fewer side effects.</p>

Differential expression of microRNAs in the late stage terminal hindgut development in fetal rats / 中华实用儿科临床杂志

Objective To detect the expression of microRNA(miRNAs)in the late stage terminal hindgut de-velopment in fetal rats.Methods Twenty -four female rats were randomly divided into 2 groups.They were matched in proportion of male and female 21 .The experimental rats(n =1 2)received 1 0 g/L ethylenethiourea (1 25 mg/kg)by gavage on gestational day 1 1 ,and the control rats (n =1 2)received same amount of distilled water.The fetal rats were obtained by caesarean section on the gestational day 1 6 in each group.One centimeter rectum was taken out from 2 similar weight fetal rats for extracting total RNA by Trizol method.There were 24 fetal rats in each group.Chip hybri-dization was conducted after Poly(A)and biotin added to the RNA.Then,the chip was washed and dyed,and scanned thereafter.According to the differences in the expression profile of miRNAs and target gene analysis results,the miRNAs probably regulating the key gene of hindgut development was selected for target genes expression analysis.Results Compared with control group,expressions of 1 1 1 miRNAs in terminal hindgut of experimental group were up -regulated on the gestational day 1 6,and 1 1 7 miRNAs were down -regulated.Ten miRNAs of biggest differential expression be-tween them were selected for target genes prediction,pathway analysis,and Gene Ontology analysis.The results showed that some genes were closely related to rat fetus terminal hindgut growth and development,such as Shh,Hoxd13,and so on.According to the differential expression of miRNAs and target genes analysis,miR -1 93 might have an important role in the Hoxd13 gene for anorectal development.Real -Time PCR and Western blot showed that the expression of Hoxd13 and its protein level were significantly decreased when miR -1 93 highly expressed in rat intestinal epithelial cells,and the difference was statistically significant compared with the control group(1 .00 ±0.1 2 vs 0.71 ±0.1 0) (0.88 ±0.06 vs 0.75 ±0.08)(t =3.329,3.1 30;P =0.029,0.01 1 ).Conclusions miRNAs probably have an im-portant regulatory role in their target gene expression in terminal hindgut development of fetal rats,and miR -1 93 can significantly inhibit the expression of Hoxd13 gene in rat intestinal epithelial cells.