Prevention and treatment of lung cancer by regulating tumor-associated macrophages with traditional Chinese medicine / 中国中药杂志

Lung cancer is one of the common malignant tumors in the world, and its incidence and mortality is increasing year by year. Interactions between tumor cells and immune cells in the tumor microenvironment(TME) affect tumor proliferation, infiltration, and metastasis. Tumor-associated macrophages(TAMs) are prominent components of TME, and they have dual regulation effects on malignant progression of lung cancer. The number, activity, and function of M2 macrophages are related to the poor prognosis of lung cancer, and M2 macrophages participate in tumor angiogenesis and immune escape. It has been proved that traditional Chinese medicines(TCMs) and their active ingredients can enhance the antitumor effects, reduce the toxicity of chemotherapy and radiotherapy, and prolong the survival rates of patients with cancer. This paper summarized the role of TAMs in the lung cancer initiation and progression, explored the molecular mechanism of TCM in regulating the recruitment, polarization phenotype, activity, and expression of related factors and proteins of TAMs, and discussed related signal pathways in the prevention and treatment of lung cancer based on the TCM theory of "reinforcing healthy qi and eliminating pathogen". This paper is expected to provide new ideas for the immunotherapy of targeted TAMs.

Baicalin Alleviates LPS-Induced Acute Lung Injury in Rats Through p38 MAPK/NLRP3 Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effects and mechanism of baicalin （BA） on lipopolysaccharide （LPS）-induced acute lung injury in rats. MethodEighty healthy male SD rats were randomly divided into the control group， model group， low-dose BA （BA-L） group， medium-dose BA （BA-M） group， high-dose BA （BA-H） group， dexamethasone （DEX） group， SB203580 group， and BA + SB203580 group， with 10 rats in each group. The rats in the BA-L， BA-M， and BA-H groups were injected intraperitoneally with different doses （10， 50， 100 mg·kg-1） of BA solution， the ones in the DEX group with 5 mg·kg-1 DEX solution， the ones in the SB203580 group with 0.5 mg·kg-1 SB203580 solution， the ones in the BA + SB203580 group with 100 mg·kg-1 BA solution and 0.5 mg·kg-1 SB203580， and those in both the control group and model group with the same volume of normal saline， once per day， for seven successive days. One hour after the last administration， rats in all groups except for the control group were given 5 mg·kg-1 LPS via intratracheal instillation for inducing the acute lung injury， whereas those in the control group received the same volume of normal saline solution. Twelve hours later， the lung tissues were sampled and stained with htoxylin-eosin （HE） for observing the pathological changes， followed by the counting of the total number of cells and neutrophils in bronchoalveolar lavage fluid （BALF）. The wet/dry weight ratio of the lung tissue and the contents of serum superoxide dismutase （SOD） and malondialdehyde （MDA） were measured. The activity of reactive oxygen species （ROS） in the lung tissue was detected by immunofluorescence and the levels of interleukin-1β （IL-1β）， interleukin-18 （IL-18）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in BALF by enzyme-linked immunosorbent assay （ELISA）. Immunohistochemistry （IHC） was conducted to determine the relative expression of p-p38 mitogen-activated protein kinase （MAPK） and Western blotting was carried out to detect the protein expression levels of p-p38 MAPK， thioredoxin interacting protein （TXNIP）， NOD-like receptor protein 3 （NLRP3）， and cysteinyl aspartate specific protease-1 （Caspase-1） in the lung tissue. ResultCompared with the control group， the model group displayed inflammatory pathological changes in lung tissue， elevated wet/dry weight ratio， total number of cells and neutrophils in BALF， and ROS and MDA levels （P<0.01）， decreased SOD activity （P<0.01）， and up-regulated IL-1， IL-18， IL-6， TNF-α， p-p38 MAPK， NLRP3， and Caspase-1 expression （P<0.01）. Compared with the model group， BA at different doses， SB203580， and BA + SB203580 all effectively alleviated the pathological changes in lung tissue induced by LPS， reduce the lung wet/dry weight ratio， the total number of cells and neutrophils in BALF， and ROS and MDA levels （P<0.05，P<0.01）， enhanced the activity of SOD （P<0.05，P<0.01）， and down-regulated the expression of IL-1β， IL-18， IL-6，TNF-α， p-p38 MAPK， NLRP3， and Caspase-1 in lung tissue （P<0.05，P<0.01）. ConclusionBA has a protective effect against LPS-induced acute lung injury， which may be related to its inhibition of p38MAPK/NLRP3 signaling pathway and the improvement of inflammatory response.

Neurodevelopmental features of preterm infants at the corrected age of 1 year / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the neurodevelopmental level of preterm infants at the corrected age of 1 year and the effect of complications on neurodevelopment.</p><p><b>METHODS</b>The clinical data and follow-up data of hospitalized preterm infants were retrospectively studied. The Bayley Scales of Infant Development was used to assess the neurodevelopmental level. Preterm infants were divided into groups according to gestational age, birth weight, and the presence or absence of complications. The mental development index (MDI) and psychomotor development index (PDI) were compared between groups.</p><p><b>RESULTS</b>At the corrected age of 1 year, compared with the late preterm infants, the early preterm infants had significantly lower MDI and PDI (P<0.05) and significantly higher rates of retarded intellectual and psychomotor development (P<0.01). Compared with the normal birth weight group, the low birth weight group had significantly lower MDI and PDI (P<0.01) and significantly higher rates of retarded intellectual and psychomotor development (P<0.01). The preterm infants with hyperbilirubinemia, birth asphyxia or neonatal respiratory distress syndrome (NRDS) had significantly lower MDI and PDI than those without such complications (P<0.05).</p><p><b>CONCLUSIONS</b>Lower gestational age and birth weight are associated with worse intellectual and psychomotor development in preterm infants. Complications, such as hyperbilirubinemia, birth asphyxia and NRDS, have adverse effects on neurodevelopment of preterm infants.</p>

Longitudinal study of early neural development in premature infants with different gestational age and birth weight / 临床儿科杂志

Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.

Clinical manifestations, neuroimaging features, treatment, and follow-up in four pediatric patients with glutaric aciduria type Ⅰ / 中华临床营养杂志

Objective To investigate the clinical features,magnetic resonance imaging (MRI),treatment,and follow-up of patients with glutaric aciduria type Ⅰ (GA-1).Methods Four pediatric patients with GA-1 diagnosed in our hospital were included in this study.They were treated with special diets and carnitine supplements.MRI and tandem mass spectrometry (MS/MS) were performed,and the mental development indices were measured.Results GA-1 was confirmed 2 months,13 months,4 months,and 7 months after birth.Seizure had been observed before the disease diagnosis in three patients and disappeared after treatment.In all four patients,T2-weighted brain MRI showed frontotemporal atrophy or hypoplasia and enlarged subarachnoid space in the sylvian fissures and anterior to the temporal lobes.Diffusion weighted imaging revealed high-density lesions over both the putamen and globus pallidus.The patients were followed up for 4 to 5 years.Plasma amino acids and acylcamitine profile were monitored every 3-5 months.The mean C5DC level and C5DC/C8 were kept the higher limits of the normal ranges,especially in case 3.During the follow-up,the body weight was at-2 SD-0 and the height at-1 SD-0.Intellectual development test showed that case 1 and case 4 had mildly abnormal intelligence,whereas case 2 and case 3 had extremely severe intellectual disability.Gene test confirmed the presence of gene mutations in all four cases,including IVS10-2A ＞ C homozygous mutation in cases 1,3,and 4 and [IVS10-2A ＞ C] + [c.245G ＞c(p.Arg82Pro)] hybrid mutation in case 2.Two female children were smoothly enrolled by local kindergarten,while two male children were unable to walk alone due to delayed motor development and spastic paralysis.Conclusions The phenotype of GA-1 patients is not remarkably correlated with its genotype correlation.Newborn screening is essential for identifying GA-1 patients.

Study on the feasibility and safety of measles vaccination in women of childbearing age / 中华传染病杂志

Objective To study the feasibility and safety of measles vaccination in women of childbearing age and to understand the influence of measles vaccination on the fetal transmission measles antibody level of the infants.Methods From January 1,2012 to December 31,2012,600 women of childbearing age were included in this study.The measles IgG antibody was detected,then all participants were randomized according to the IgG level.The measles IgG antibody of participants in non-vaccinated group was detected predelivery in hospital by enzyme linked-immunosorbent assay (ELISA).That of participants in vaccinated group was detected 3 months after vaccination with measles mumps rubella combined vaccine and predelivery by ELISA.And measles nuclear protein fragment gene (measles virus nucleoprotein,MVN) in the blood was detected by reverse transcription polymerase chain reaction (RT PCR).A total of 368 participants gave birth within 2 years after vaccination,and 357 infants 8 months after birth were healthy.In non-vaccinated group,8 infants were diagnosed with measles within 8 months after birth.Finally,349 8-month infants were enrolled in the study,including 52 whose mothers in high antibody without vaccination group,65 whose mothers in high antibody with vaccination group,110 whose mothers in low antibody without vaccination group and 122 whose mothers in low antibody with vaccination group.The measles IgG antibody levels in the blood of all the 8-month infants were detected.Data were analyzed using t test,one-way ANOVA (Newman-Keuls was used for comparison between groups) and Pearson analysis.Results The measles IgG antibody level of expectant women in high antibody without vaccination group was significantly lower compared to that in high antibody with vaccination group ([268.5±74.9] IU/mL vs [578.3t208.1] IU/mL,Q=15.57,P＜0.01).That in low antibody without vaccination group was also significantly lower than low antibody with vaccination group ([169.4+42.3] IU/mL vs [584.7+195.8] IU/mL,Q=29.54,P＜0.01).The results of MVN RT-PCR after 3 months of vaccination showed no positive bands in all blood samples.Two of the expectant women in high antibody without vaccination group and one in low antibody without vaccination group were positive for MVN bands.Among 8-month infants,the levels of antibody in high antibody without vaccination group and high antibody with vaccination group were (106.3 ± 36.8) IU/mL and (291.8±86.5) IU/mL,respectively,which was statistically different (t=23.33,P＜0.01).Those in low antibody without vaccination group and low antibody with vaccination group were (87.1 ± 26.4) IU/mL and (274.0±72.5) IU/mL,respectively,which was statistically different (t =33.27,P＜0.01).The measles antibody level of expectant women was positively correlated with their 8-month infants (r=0.652,P＜0.01).All 8 infants who were diagnosed with measles were delivered by women without vaccination,and the measles infection rate of infants was significantly different between women with and without vaccination (P=0.002).Condusion It is feasible for women of childbearing age to receive measles vaccination,which can increase the measles IgG antibody level of both expectant women and their infants.

Evaluation of intravenous immunoglobulin in the treatment of severe EV71 infection in children / 中国基层医药

Objective To evaluate the efficacy of intravenous immunoglobulin (IVIG) in the treatment of severe EV71 infection in children.Methods The clinical data of children with severe EV71 infection,who admitted in our hospital from January 2010 to November 2012 were retrospectively analyzed.According to the time of admission and treatment principles,the patients were divided into the 2010 group and the 2012 group.The patients of the 2010 group routinely received IVIG treatment,but patients in the 2012 group received IVIG treatment in serious condition.The obvious effective rate,effective rate,ineffective rate,the incidence rate of critically ill and mortality of the two groups were compared.Results There were no significant differences in the obvious effective rate (86.0％ and 85.2％),effective rate (9.6％ and 11.8％),ineffective rate (4.4％ and 3.0％),the incidence rate of critically ill (4.0％ and 2.2％) between the two groups (x2 =0.011,1.269,1.657,3.304,all P ＞ 0.05).The mortality of the 2010 group (2.8％) was higher than that of the 2012 group (0.6％)(x2 =8.213,P ＜0.05).Conclusion IVIG has no effect on patients with severe EV71 infection,and is not recommended.

Progress of treatment for status epilepticus in children / 中国小儿急救医学

Status epilepticus(SE)is one of the most common medical emergencies in children.There has been some recent understanding of this fife-threatening condition with reference to the definition,forms of ignorable seizure,drug treatment and role of EEG monitoring.This review discusses the current information regarding the definition,diagnosis,treatment of status epilepticus and the latest advance on management of refractory SE in children.

Contents of serum albumin after surgical operation in children with acute intussusception / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes of serum albumin contents after operation and investigate whether post-operational serum albumin contents are correlated with the disease severity in children with acute intussusception.</p><p><b>METHODS</b>Serum albumin contents were measured using the automatic biochemistry analyzer in 32 children with mild acute intussusception and 21 children with severe acute intussusception 1 day after surgical operation. After 5 days combined treatment, serum albumin contents were re-examined. Thirty healthy children severed as the control group. The correlation between post-operational serum albumin contents and critical illness scores was evaluated.</p><p><b>RESULTS</b>Serum albumin contents in the mild (34.2+/-6.5 g/L; P<0.05) and the severe intussusception groups (25.8+/-7.5 g/L; P<0.01) 1 day after operation were significantly lower than those in the control group (37.1+/-4.1 g/L). There were significant differences in serum albumin contents between the mild and the severe intussusception groups (P<0.05). Five days after operation, serum albumin contents in the mild intussusception group significantly increased (37.1+/-11.4 g/L; P<0.05), while serum albumin contents in the severe intussusception group did not differ from those 1 day after operation. There was a positive correlation between serum albumin contents on the 1st day after operation and the critical illness scores (r=0.879, P<0.01).</p><p><b>CONCLUSIONS</b>Serum albumin contents decreased on the 1st day after operation and were correlated with the disease severity in children with acute intussusception. Hypoalbuminemia lasted for a longer period in severe cases. The post-operational measurement of serum albumin contents may be useful in the evaluation of the severity for children with acute intussusception.</p>

Three cases of enterovirus 71 infection with pulmonary edema or pulmonary hemorrhage as the early clinical manifestation / 中华儿科杂志

<p><b>OBJECTIVE</b>To recognize the clinical features of the enterovirus 71 (EV71) infection with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness.</p><p><b>METHODS</b>We retrospectively reviewed the medical records of the three cases with EV71 infection for clinical manifestation, laboratory data, medications, outcome etc.</p><p><b>RESULTS</b>All the cases were infants and they all died. These infants had no skin or mucosal lesions, however, they had sudden onset of cyanosis and tachypnea 1 to 2 days after the onset of the febrile disease with vomiting. All these 3 cases were misdiagnosed and were treated for shock on admission. Pulmonary hemorrhage was not considered in any of the cases on admission. All the cases received tracheal intubation when foamy secretions were discharged from mouth and nose of the patients and notable cyanosis was noted. After intubation, all had pink foamy fluid flew out from the endotracheal tube. The patients had hyperglycemia and limb weakness, two had tachycardia, and hypertension was found in one case. Chest X-ray showed bilateral or unilateral widespread air space opacity, but the cardiac size and shape were normal. All the patients had leucocytosis. EV71 infection was confirmed by detection of specific sequences of the virus in throat swab and tracheal secretions samples and in one case in cerebrospinal fluid sample.</p><p><b>CONCLUSION</b>Pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71-infected infants. The initial presentation was often nonspecific with fever and vomiting, and sudden appearances of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment.</p>