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Objective@#To investigate the clinical, imaging and molecular characteristics of primary hyperoxaluria type 1 (PH1) in children and to sum up existing evidence for further understanding the phenotype-genotype correlation of infantile PH1.@*Methods@#This retrospective analysis was based on the medical records of children with PH1 diagnosed by gene test in the Department of Nephrology, Guangzhou Women and Children′s Medical Center from June 2016 to May 2019. Targeted exome sequencing was performed on tubular disease-related genes of the probands and Sanger sequencing was conducted to validate suspected pathogenic variants of family members. Logistic regression analysis of NC and CCr was adopted to show the relation between NC and renal function. The literature review was conducted, and the clinical, imaging and molecular biogenetic characteristics of the disease were analyzed and summarized.@*Results@#A total of 7 children from 6 families were enrolled. The median age of onset was 5 months. The median age of diagnosis was 8 months. Five cases had progressed to end-stage renal disease (ESRD), one case had chronic kidney disease (CKD) stage 1, and the other one had CKD stage 2. Four cases died, one case maintained on hemodialysis, and the other two non-dialysis cases were followed up. Among the 7 cases, 4 patients had infantile PH1, 1 patient had child and adolescent type, 1 patient had family type and the other one had unknown classification. There were two siblings (the younger brother had uremia and the sister had normal renal function) who had the delayed diagnosis for 5 and 3 years respectively. All patients in this cohort had proteinuria and microscopic hematuria, but no patients had gross hematuria. Three cases had hypercalciuria. Comprehensive diagnostic imaging evaluation include CT scan, MR scan, radiography and ultrasound led to the diagnosis of nephrocalcinosis (NC) in 5 cases, including 4 cases of simple NL and 1 case of NC with nephrolithiasis (NL), 1 case of multiple NL and 1 case of microcrystal deposition in renal medulla. However, only one case of NC was identified by ultrasound, the other 4 cases of NC were identified by radiograph examination. In the logistic regression analysis involving NC and creatinine clearnce rate (CCr), the results showed that NC was an independent risk factor for renal dysfunction (OR 2.5, 95%CI 0.7-1.2, P<0.05). All the 7 cases had AGXT gene variant, including homozygous variant in 4 cases and compound heterozygous variant in 3 cases. A total of 9 variant genotypes were found, and exon 6 variants were found in 4 children. Among them, there were 3 cases with c.679_680delAA. To our knowledge, both c.679_680delAA and c.190A>T in the cohort have not been reported previously.@*Conclusions@#Infantile PH1 is the most common type of PH1 in children, which progresses rapidly or even begins with renal failure, with poor prognosis. It is also highly heterogeneous in phenotype and genotype. NC is an independent risk factor leading to renal failure. Radiograph examination showed high specificity for the diagnosis of NC. At present, the misdiagnosis and delayed diagnosis of PH1 are still common in China. It is of great significance to carry out quantitative determination of uric oxalate in order to reduce the misdiagnosis rate and enhance follow-up technologies for evaluating the therapeutic effect.
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Objective To investigate the causal association between hip circumference (HC) and type 2 diabetes mellitus (T2DM) based on Mendelian randomization. Methods The genetic variants data of the HC and T2DM from the Genetic Investigation of Anthropometric Traits (GIANT) and DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) database were matched according to the single nucleotide polymorphism (SNP) rsID. Genetic loci strongly related to the HC were used as instrumental variables; and the inverse-variance weighting, MR-Egger regression model and weighting median method were carried out to analyze the causal effect of HC on T2DM. Results Fifty-two, nine and fifteen SNPs were matched in the total cohort, female cohort and male cohort, respectively. Heterogeneity test suggested the SNPs were homogeneous. We found HC to be positively associated with T2DM risk (OR=1.065, 95% CI: 1.030-1.100, OR=1.103, 95% CI: 1.057-1.150 and OR=1.583, 95% CI: 1.273-1.968, respectively) in above three cohorts, respectively. Sensitivity analysis showed the results were robust. Conclusions There is a relationship between HC and T2DM of people, and HC may be the risk factor of T2DM.
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Objective To investigate the protective effect of brain derived neurotrophic factor (BDNF) on Müller cells in the retina of diabetic rats.Methods A total of 54 healthy male SD rats were recruited and randomly divided into control group,diabetic group and BDNF group.Then a diabetic model was established by intraperitoneal injection of streptozotocin in rats of diabetic and BDNF groups.Preparation of BDNF injection was performed using PBS balanced salt solution containing 0.1 g · L 1 BSA.The BDNF group was given BDNF injection,while the control and diabetic group were injected with equal dose of PBS balanced salt solution 4 weeks after successful modeling.And after 8 weeks,the expression of L-glutamate/L-aspartate transporter (GLAST),glutamine synthetase (GS) and synaptophysin (SYN) were detected by immunofluorescence technique and Western blot,and the content of glutamic acid in retina was determined by glutamic acid determination kit.Results Compared with the control group,the expression of GLAST,GS and SYN were significantly decreased in diabetic group,and the content of glutamic acid was increased significantly (all P ＜ 0.01).Compared with the diabetic group,the expression of GLAST,GS and SYN were increased in BDNF group,and the glutamate level was decreased significantly (all P ＜0.01).Conclusion In the early stage of diabetic retinopathy,administration of exogenous BDNF can unregulated the expression of GLAST,SYN and GS and improve the function of Müller cells to protect RGC against damage,suggesting that BDNF has neuroprotective effects on Müller cells in retina of rats with diabetic retinopathy.
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Objective To analyze the long-term prognosis and prognostic factors of idiopathic collapsing focal segmental glomerulosclerosis (FSGS) and not otherwise specified FSGS in children. Methods The clinical, pathology and follow-up data of patients with idiopathic collapsing FSGS and not otherwise specified FSGS were analyzed retrospectively by Kaplan-Meier method, univariate and multivariate Cox regression analysis. Results A total of 64 patients (29 idiopathic collapsing FSGS and 35 not otherwise specified FSGS) were diagnosed by renal biopsy. The 4-year renal survival rate of idiopathic collapsing FSGS and not otherwise specified FSGS were 48.3%, 74.3% respectively. Univariate analysis revealed that the renal survival time were 25.41±3.28 months in idiopathic collapsing patients, and 35.53±2.73 months in not otherwise specified patients. The different is significant (χ2=4.07,P=0.044). Multivariate Cox regression analysis showed that poor treatment response (HR=5.92, P<0.05) and renal insufficiency at early stage (HR=2.45, P<0.05) were independent risk factors of prognosis. Conclusions Compared with patients with not otherwise specified FSGS, the renal survival time is shorter in idiopathic collapsing FSGS patients. Patients with renal insufficiency and poor response to treatment have poorer prognosis.
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Life course epidemiology should practically illustrate how risk exposures and their dynamic changes influence the occurrence, development and prognosis of chronic diseases from early life to the elderly. This paper develops the lifespan risk exposure measurement instrument (LREMI) in the framework of retrospective study to collect lifestyle, diet, physical activity information across subjects'life courses from 18-years-old to current age. Through a pilot study, the result of the test-retest analysis demonstrated the reliability of LREMI. In Shandong Multicenter Cohort, the LREMI showed its feasibility, for it could measure the exposure spectrum on both individuals and population with different life experiences. Moreover, it had good differentiation ability for identifying cases versus controls in population-based case-control study. However, further studies should be conducted in an already available prospective cohort to ascertain that our results could match prospective data.
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Humans , Environmental Exposure , Epidemiologic Methods , Life Style , Retrospective StudiesABSTRACT
Objective To establish the finite element model of knee joint and investigate changes of stress and strain in normal and cartilage sclerosis cases, so as to provide reference for clinical treatment of the knee osteoarthritis. Methods CT scanning images of normal knee joint were used to establish the 3D finite model using Mimics and ANSYS software. Loadings of 350 N pressures were applied on the model of normal knee joint and knee joint with cartilage sclerosis, respectively. The related material parameters of cartilage before and after sclerosis were set, and the Von Mises stress and strain changes of the knee joint were then analyzed. Results In case of cartilage sclerosis, the function of shock absorption and load transfer in articular cartilage basically disappeared. The stress and strain on the femur changed with uneven distribution, showing more obviously than those on the inner and outer condyle, and the overall stresses were increased obviously. The largest stress and strain occurred on the meniscus. Conclusions The long-term cartilage destruction will affect nutrient metabolism of articular cartilage and cause the deterioration of osteoarthritis diseases. This study can preferably explain the pathogenic mechanism of osteoarthritis, and also provide relevant data for establishing parametric study system.
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OBJECTIVE@#To investigate the genetic polymorphisms of 15 X-STR loci in Shandong Han population in order to establish the forensic application database.@*METHODS@#The multi-PCR primers of these loci were designed by Primer Premier 5.0 software and labeled by 4 fluoresceins (FAM, VIC, NED and TET). The developed multi-PCR was used to investigate 15 X-STR loci (DXS10011, DXS101, GATA 165B12, DXS6795, DXS6800, DXS6801, DXS6803, DXS7132, DXS7133, DXS7423, DXS7424, DXS8377, DXS8378, DXS9898 and HPRTB) selected from the X chromosome of 481 unrelated individuals (295 females and 186 males) in Shandong Han population.@*RESULTS@#Among the 15 X-STR loci, GATA 165B12, DXS6800, DXS6803, DXS7133 and DXS7423 showed moderate polymorphisms, while the rest 10 X-STR loci showed high polymorphisms (PIC > 0.5 and H > 0.5). No shared haplotype was detected among the males in Shandong Han population.@*CONCLUSION@#The developed multi-PCR system with fluorescence detection provides an effective way to establish X-STR loci database of population genetics in Shandong Han population and shows its forensic application.
Subject(s)
Female , Humans , Male , Asian People/genetics , China , Chromosomes, Human, X/genetics , DNA Fingerprinting , DNA Primers , Forensic Genetics , Gene Frequency , Genetic Linkage , Genetics, Population , Genotype , Microsatellite Repeats , Multiplex Polymerase Chain Reaction , Polymorphism, GeneticABSTRACT
Objective To investigate the spatial distribution and clustering areas of Budd-Chiari syndrome in Heze City,Shandong Province,and to provide epidemiological information for further exploring the etiology and related risk factors of the disease.Methods Detailed residential addresses of 342 cases of patients (residents of Heze City) with diaphragm type Budd-Chiari syndrome diagnosed between 1995 and 2004 in Heze Municipal Hospital,Heze Shan County Central Hospital,Affiliated Hospital of Xuzhou Medical College,Shandong Provincial Hospital and Beijing Xuanwu Hospital were collected.Geographic information system (GIS) was used as a platform for data management and display.The nearest neighbor index,Ripley's K(d) function,Ripley's L(d) function and the nearest neighbor clustering method were applied to detect the spatial characters of Budd-Chiari syndrome in Heze City,Shandong Province.Crimestat 3.0 was used for spatial analysis.Results The nearest neighbor distance analysis showed that the nearest neighbor index was 0.6767 (Z =-11.4387,P ＜ 0.01).That was an aggregation at the first-order spatial scale.Within the study area,the first clustering radius of Budd-Chiari syndrome was 6.66 km,and the first clustering strength was 5.40; the average radius of the strongest clustering area was 126.61 km,and the clustering strength was 12.52,while the biggest clustering radius was larger than 222 km.After corrected by population,the gathering strength was slightly higher than that before the correction.Ten first-order hot spots were formed,and 95％ confidence interval aggregation number was 7,which meant the results were statistically significant(P ＜ 0.05),main clustering areas are in Mudan District,Shan County and Juancheng.One secondorder hot spot was gathered based on the first-order hot spot.Conclusions Spatial distribution of Budd-Chiari syndrome in Heze City,Shandong Province has showed spatial aggregation and heterogeneity.This study has a great epidemiological significance for further exploring the cause of Budd-Chiari syndrome.
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<p><b>OBJECTIVE</b>To evaluate the relationship between lifestyle habits and the components of metabolic syndrome (MS).</p><p><b>METHODS</b>Based on the routine health check-up system in a certain Center for Health Management of Shandong Province, a longitudinal surveillance health check-up cohort from 2005 to 2010 was set up. There were 13 225 urban workers in Jinan included in the analysis. The content of the survey included demographic information, medical history, lifestyle habits, body mass index (BMI) and the level of blood pressure, fasting blood-glucose, and blood lipid, etc. The distribution of BMI, blood pressure, fasting blood-glucose, blood lipid and lifestyle habits between MS patients and non-MS population was compared, latent variables were extracted by exploratory factor analysis to determine the structure model, and then a partial least squares path model was constructed between lifestyle habits and the components of MS.</p><p><b>RESULTS</b>Participants'age was (46.62 ± 12.16) years old. The overall prevalence of the MS was 22.43% (2967/13 225), 26.49% (2535/9570) in males and 11.82% (432/3655) in females. The prevalence of the MS was statistically different between males and females (χ(2) = 327.08, P < 0.01). Between MS patients and non-MS population, the difference of dietary habits was statistically significant (χ(2) = 166.31, P < 0.01) in MS patients, the rate of vegetarian, mixed and animal food was 23.39% (694/2967), 42.50% (1261/2967) and 34.11% (1012/2967) respectively, while in non-MS population was 30.80% (3159/10 258), 46.37% (4757/10 258), 22.83% (2342/10 258) respectively. Their alcohol consumption has statistical difference (χ(2) = 374.22, P < 0.01) in MS patients, the rate of never or past, occasional and regular drinking was 27.37% (812/2967), 24.71% (733/2967), 47.93% (1422/2967) respectively, and in non-MS population was 39.60% (4062/10 258), 31.36% (3217/10 258), 29.04% (2979/10 258) respectively. The difference of their smoking status was statistically significant (χ(2) = 115.86, P < 0.01) in MS patients, the rate of never or past, occasional and regular smoking was 59.72% (1772/2967), 6.24% (185/2967), 34.04% (1010/2967) respectively, while in non-MS population was 70.03% (7184/10 258), 5.35% (549/10 258), 24.61% (2525/10 258) respectively. Both lifestyle habits and the components of MS were attributable to only one latent variable. After adjustment for age and gender, the path coefficient between the latent component of lifestyle habits and the latent component of MS was 0.22 with statistical significance (t = 6.46, P < 0.01) through bootstrap test. Reliability and validity of the model:the lifestyle latent variable: average variance extracted was 0.53, composite reliability was 0.77 and Cronbach's a was 0.57. The MS latent variable: average variance extracted was 0.45, composite reliability was 0.76 and Cronbach's a was 0.59.</p><p><b>CONCLUSION</b>Unhealthy lifestyle habits are closely related to MS. Meat diet, excessive drinking and smoking are risk factors for MS.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Life Style , Longitudinal Studies , Metabolic Syndrome , Epidemiology , Models, Statistical , Prevalence , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To take effective strategies and measures for the prevention and control of hemorrhagic fever with renal syndrome (HFRS) endemic areas by investigating its dynamic geographical boundaries in Shandong Province, China.</p><p><b>METHODS</b>The incidence of HFRS from 1982 to 2008 in Shandong Prvince, China, was detected with inverse distance weighting (IDW) interpolation based on geographical information system (GIS). Dynamic geographical boundaries of HFRS endemic areas in Shandong Province, China, were analyzed by geographical boundary analysis.</p><p><b>RESULTS</b>The HTN-type endemic areas of HFRS were located in Linyi City in phase 1 (1982-1986), the SEO-type endemic areas of HFRS were located in Jining City in phase 2 (1987-2003), and the endemic areas of HFRS in Jining City gradually disappeared and the endemic areas of HFRS with mixed-types of reservoir rodents were located in Linyi City in phase 3 (2004-2008). Meanwhile, new endemic areas emerged in the northwestern Shandong province, China.</p><p><b>CONCLUSION</b>The SEO-type endemic areas of HFRS are located in western Shandong Province, China, and the HTN-type endemic areas of HFRS are located eastern Shandong Province, Chin, indicating that the endemic areas of HFRS should be vaccinated and rodents should be controlled.</p>
Subject(s)
Humans , China , Epidemiology , Endemic Diseases , Geography , Hemorrhagic Fever with Renal Syndrome , Epidemiology , Population SurveillanceABSTRACT
Objective To observe the effects of comprehensive measures of changing grain,selenium supplementation,off-site education and resettlement on prevention of children's Kashin-Beck disease in Aba state.Methods Fifty eight villages in Aba Kashin-Beck disease areas were chosen as intervention points in Aba state Sichuan province from 2007 to 2011.Based on the implementation of prevention and control measures,the villages were divided into off-site education + changing grain + selenium supplementation group and resettlement + off-site education + changing grain + selenium supplementation group,Geletuo town of Seda county,Ganzi state was selected as a control point,and right-hand anteroposterior X-ray examination(including the wrist) was carried out on children aged 6-13 from 2007 to 2011 annually.Clinical and X-ray diagnosis of Kashin-Beck disease was made in accordance with the Diagnostic Criteria of Kaschin-Beck Disease(GB 16003-1995).The effects of prevention and control measures were evaluated by comparing the child X-ray detection rate before and after the implementation of the measures.Results The average X-ray positive detectable rate of children in the intervention points was 2.07％(66/3181),2.72％ (69/2540),1.16％ (35/3017),0.56％ (19/3397) and 0.56％ (24/4273),respectively from 2007 to 2011,with a downward trend (x2trend =66.74,P ＜ 0.01).There was a downward trend in the average X-ray positive detectable rate of children in off-site education + changing grain + selenium supplementation group [1.60％(29/1809),2.63％ (39/1484),1.29％ (25/1941),0.64％ (15/2332),0.42％ (10/2379)] and resettlement + off-site education + changing grain + selenium supplementation group [2.70％ (37/1372),2.84％ (30/1056),0.93％(10/1076),0.38％ (4/1065),0.74％(14/1894)] (x2trend=30.97,35.19,all P ＜ 0.01).The average X-ray positive detectable rate of children in the intervention group was 0 from 2007 to 2010,and was 1.61％ (1/62) in 2011.The difference of X-ray positive detectable rate was not statistically significant in the control group in the 5 years from 2007 to 2011.The difference of children's X-ray positive detectable rate was not statistically significant between control group and intervention group.Conclusions The effect of taking changing grain,selenium supplementation,off-site education and resettlement comprehensive measures to prevent children's Kashin-Beck disease is not significant in those places where the state of Kaschin-Beck disease is not active.
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<p><b>OBJECTIVE</b>To study mechanism of the apoptosis of rat pancreas islet β cell strain (INS-1 cells) induced by sodium arsenite.</p><p><b>METHODS</b>INS-1 cells were exposed to sodium arsenite at the different concentrations. MTT assay was used to detect the viability of INS-1 cells. The potentials on mitochondrial membrane and lysosome membrane of INS-1 cells were determined with the fluorescence spectrophotometer. The apoptotic levels of INS-1 cells exposed to sodium arsenite were observed by a fluorescence microscope and flow cytometry.</p><p><b>RESULTS</b>After exposure to sodium arsenite, the viability of INS-1 cells significantly decreased with the doses of sodium arsenite. At 24 h after exposure, the OD values of the mitochondrial membrane potentials declined observably with the doses of sodium arsenite (P < 0.01). At 48 h after exposure, the OD values of the lysosome membrane potentials significantly increased with the doses of sodium arsenite (P < 0.01). At 72 h after exposure, the apoptotic cells were observed under a fluorescence microscope and enhanced with the doses of sodium arsenite. The apoptosis cells with light blue, karyopyknosis, karyorrhexis, apoptotic body and chromatin concentration appeared. The results detected with flow cytometry indicated that after exposure, the apoptotic INS-1E cells significantly increased with the doses of sodium arsenite.</p><p><b>CONCLUSIONS</b>The sodium arsenite can induce the apoptosis of INS-1 cells through the mitochondria-lysosome pathway.</p>
Subject(s)
Animals , Rats , Apoptosis , Arsenites , Toxicity , Cells, Cultured , Insulin-Secreting Cells , Lysosomes , Metabolism , Membrane Potentials , Mitochondria , Metabolism , Sodium Compounds , ToxicityABSTRACT
<p><b>BACKGROUND</b>Hemorrhagic fever with renal syndrome (HFRS) is endemic in Junan county, Shandong Province, China. We conducted geographic information system (GIS)-based spatial analysis with the objective of estimating the spatial distribution of rodent populations and their hantavirus infection patterns, to describe the spatial relationships of hantavirus strains in small ecological areas and to identify key areas in endemic areas of HFRS for future public health planning and resource allocation.</p><p><b>METHODS</b>Rodent sampling was conducted in seven villages in Junan county from February 2006 to January 2007 using field epidemiological surveillance. Dynamics of hantavirus infection and population densities in rodents were investigated. Spatial statistical techniques including Ripley' L index and nearest neighbour hierarchical (NNH) clustering analysis were conducted to reveal the spatial structure of rodent populations in seven villages. Phylogenetic analysis and two-dimensional minimal spanning tree (2-D MST) models were employed to describe the spatial relationship of hantavirus strains.</p><p><b>RESULTS</b>Data showed that Mus musculus was the most common species in our study area, followed by Rattus norvegicus. Ripley's L index and NNH analysis showed that the spatial distribution of all captured rodents, Mus musculus and Rattus norvegicus in seven villages were clustered and there were hotspot areas of rodent distribution. The branches of 2-D MSTs had similar topologies to those of corresponding phylogenetic trees, and hantavirus strains exhibited obvious connective traces in seven villages.</p><p><b>CONCLUSIONS</b>These results contribute to the understanding of the spatial distribution of rodent populations and hantavirus infection patterns in small areas, and identify priority areas within the epidemic areas for the development of a better prevention strategy against hemorrhagic fever with renal syndrome in a small ecological area.</p>
Subject(s)
Animals , Humans , Rats , Geographic Information Systems , Orthohantavirus , Hemorrhagic Fever with Renal Syndrome , Epidemiology , Virology , Rodentia , VirologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical characteristics of childhood antineutrophil cytoplasmic autoantibody (ANCA)-associated rapidly progressive glomerulonephritis.</p><p><b>METHODS</b>The medical data, including clinical manifestations, laboratory findings, and kidney pathology, of 7 children with ANCA-associated rapidly progressive glomerulonephritis were retrospectively studied.</p><p><b>RESULTS</b>The 7 patients (6 girls and 1 boy) ranged in age from 3.5-14 years, with a mean age of 9 years. A diversity of major complaints and clinical symptoms was presented in the patients. Laboratory findings were not specific. All patients had elevated ESR, BUN and serum creatinine levels as well as anaemia, hematuria and proteinuria. Urinary protein electrophoresis showed mixed proteinuria in the 7 cases. C3 was normal in 3 cases and slightly decreased in 4 cases. All were MPO-ANCA positive, and 1 out of the 7 cases was positive for PR3-ANCA. Renal biopsy displayed extensive crescentic formations and necrotic glomerulus capillary loop. A great quantity of inflammatory cell infiltration and swollen endotheliocytes of small vessels as well as vessel wall edema or necrosis were found in the interstitium. Immunofluorescence showed no or little amounts of immune complex depositions in the renal glomeruli and vessel walls. Renal function was recovered and hematuria/proteinuria disappeared or greatly relieved in 3 patients after methylprednisone and cyclophosphamide pulse therapy.</p><p><b>CONCLUSIONS</b>Children with ANCA-positive rapidly progressive glomerulonephritis present with various clinical manifestations. The diagnosis of this disorder may be difficult due to a lack of specificity in its clinical manifestations. It is important to enhance our understanding of this disorder to effectively make an early diagnosis.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Antibodies, Antineutrophil Cytoplasmic , Biopsy , Disease Progression , Glomerulonephritis , Drug Therapy , Allergy and Immunology , Pathology , Kidney , Pathology , Prednisone , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>In the past the mortality and sequelae rate of the patients with severe fluoroacetamide (FAM) poisoning treated only with traditional remedies was high. During the recent ten years the authors treated children with severe FAM poisoning with charcoal hemoperfusion (HP) and achieved better results. However evidence was not sufficient to show that reduced mortality and sequelae rates were obtained from HP without traditional treatment because of lack of prospective randomized, controlled clinical studies. Thus, a dog model for FAM poisoning was designed in order to study the therapeutic effect, high-efficiency time of HP, the time of tissue-poisoning to release after HP, and to investigate the toxicokinetics of the poison in the course of treatment and after HP.</p><p><b>METHOD</b>Fourteen dogs were given intraperitoneal FAM at a dose of 0.3 mg/kg body weight. HP was performed on 9 poisoned dogs for 30 - 120 minutes post intoxication. Each procedure lasted for 4 hours. Blood samples of the 9 poisoned dogs were collected before HP and 30, 60, 90, 120, 180, 240 minutes during HP and 2, 6, 24 hours after HP. Blood plasma was separated from blood samples and stored at -20 degrees C. The concentration of the poison was measured by gas chromatography (GC). The clinical symptoms of all the dogs were observed for one day.</p><p><b>RESULTS</b>The FAM concentration (ng/ml) of blood samples in poisoned dogs before HP, and 60, 120, 180, 240 minutes during HP were 230.11 +/- 52.48, 184.56 +/- 62.57, 141.00 +/- 44.83, 126.78 +/- 61.04, 113.11 +/- 54.65 respectively. The differences were significant (chi(2) = 31.978, P < 0.0005). The dispersion count between pre-HP and HP for 1 was 45.55, between 1 h and 2 h was 43.56, between 2 h and 3 h was 14.22 and between 3 h and 4 h was 13.67. The values of FAM had declined by 38.7%, 45.0% and 50.8% respectively at 2 h, 3 h, 4 h of HP compared with pre-HP. The rate of cleaning efficacy of FAM of every hour during HP were 19.79%, 23.6%, 10.09% and 10.78% respectively during HP 1, 2, 3, 4 h. The cleaning efficacy of HP was high within 2 hours during HP. The concentration of FAM slightly rose again 6 h after HP. The level of FAM had declined at 24 hour after HP when compared with pre-HP level. The reduction rate of FAM level for every hour during HP was higher than that after HP (12.71% vs 0.27% - 2.22%). The t(1/2) of FAM with and without HP were (4.50 +/- 1.20) h and (49.60 +/- 10.56) h. All the 5 poisoned dogs not treated with HP died. However 6 poisoned dogs treated with HP kept alive after HP. Three dogs had frequent seizures again 4h after HP. After HP the charcoal container was washed by 0.9% saline and FAM could not be detected in the douche.</p><p><b>CONCLUSIONS</b>Charcoal HP was an effective treatment for severe FAM poisoning. T(1/2) of the poison was shortened, and the poison clearing rate was accelerated by HP. The high-efficiency time of HP was 2 - 2.5 h. Activated charcoal can adsorb the poison vigorously, and return of blood to the body after HP by using 0.9% saline was feasible and safe.</p>
Subject(s)
Animals , Dogs , Charcoal , Therapeutic Uses , Fluoroacetates , Poisoning , Hemoperfusion , Methods , Metabolic Clearance Rate , Poisoning , Metabolism , Therapeutics , Poisons , Toxicity , Seizures , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>In China, with the development of public health and medical treatment, accident became the first cause of death of children aged form 1 to 14 years, and poisoning became one of the main causes. The present study was conducted to investigate the efficacy of hemoperfusion (HP) on poisoning, and the pharmacokinetics of the poison during and after HP. The study was also to observe the effect of HP on blood cell and blood biochemistry, blood flow and dosage of heparin during HP in children.</p><p><b>METHODS</b>Thirty-five children with acute poisoning (including 26 boys and 9 girls aged from 10 months to 13 years, mean 3.35 +/- 2.50 years) were treated with HP for one to three times. Among them 12 children were treated with HP for two times and 4 children for three times. Two ml blood samples of 6 children with Fluoroacetamide (FAM) poisoning and 10 children with Tetramine (TET) poisoning were collected. The concentration of poison was measured by gas chromatography (GC).</p><p><b>RESULTS</b>The poisoning symptoms of all cases were relieved or alleviated obviously. In the end, 27 (77%) cases recovered and 6 (17%) cases improved, while 2 (6%) cases died of multi-organ failure (MOF). Clinical symptom happened again 6 - 24 hours after HP in 1 case with FAM poisoning and 3 cases with TET whose clinical symptoms were relieved during HP. The PLT, RBC counts and Hb decreased significantly after HP compared with pre-HP (P < 0.05), while WBC, alanine aminotransferase (ALT), aspartate aminotransferase (AST), reatine kinase (CK), blood urea nitrogen (BUN), creatinine (CRE), Creatine kinase isoenzymes (CK-MB), total protein (TP), albumin (ALB) and globulim (GLO) after HP did not significantly change (P > 0.05). The FAM concentration was significantly reduced (P < 0.030). The concentration of TET in the poisoned children also significantly decreased with the treatment (P = 0.001). The cleaning efficacy of HP was higher during the first hour than that during the second hour of HP. The concentration of poison rose again 2 - 6 hours after HP in 1 case with FAM poisoning and 3 cases with TET poisoning, but the level was lower compared with pre-HP level. The t(1/2) of FAM and TET with and without HP was (2.40 +/- 0.66) h, (15.60 +/- 8.22) h, (4.10 +/- 1.66) h and (67.01 +/- 48.42) h, respectively. The first dose of heparin was (0.54 +/- 0.15) mg/kg; then (0.20 +/- 0.06) mg/kg was added for every 30 minutes. The velocity of blood flow was (4.39 +/- 0.99) ml/min.</p><p><b>CONCLUSIONS</b>The t(1/2) of the poison was shortened, and the poison clearing was accelerated by HP. The HP is a safe and effective therapy in children. The concentration of poison in some patient may rise again 2 to 6 hours after HP temporarily. The charcoal HP cannot remove the poison that conjugated with plasma albumin and globulin. The charcoal HP can cause temporary reduction of platelet and erythrocyte. The dosage of heparin used in children was lower than that in adult.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Blood Urea Nitrogen , Charcoal , Therapeutic Uses , China , Creatinine , Blood , Hemoperfusion , Methods , Multiple Organ Failure , Blood , Therapeutics , Neonatology , Poisoning , Blood , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To study the incidence and spatiotemporal dynamic variation of hemorrhagic fever with renal syndrome (HFRS) in Shandong province.</p><p><b>METHODS</b>According to surveillance data on HFRS epidemics and host animals, a 'contour area multifractal model' was estimated on the HFRS' incidence and multi-analysis model was applied to study spatiotemporal dynamic variation.</p><p><b>RESULTS</b>The process could be classified into 5 periods: 1st period (1974-1981) when HFRS was in completely natural focal state in Shandong, and the nature of focus was typical Apodemus type. 2nd period (1982-1986) indicated the process of expanding and merging of the Apodemus type focus in the southeastern part of Linyi district and the Rattus type focus was in the southern part of Jining city. 3rd period (1987-1990) indicated that through the expanding and merging of the two epidemic focuses,one mixed focus dominated by the Apodemus type had been formed in the hilly area of the southern and middle part of Shandong while another one dominated by the Rattus type in the Yellow River valley of the northwestern part of Shandong. 4th period (1991-1993) showed that the process of the spatial pattern of the mixed focus dominated by the Rattus type in Shandong. 5th period (1994-2004) referred to the spatial pattern of the mixed focus dominated by the Rattus became stabilized.</p><p><b>CONCLUSION</b>Evolution of the characteristics of HFRS focus in Shandong province experienced the following three processes: the simple Apodemus type and the simple Rattus type were seen separately to the mixed foci with the Apodemus type dominant and the Rattus dominant type coexisted and merged to the stable state of the mixed focus with Rattus as the dominant one.</p>
Subject(s)
Humans , China , Epidemiology , Hemorrhagic Fever with Renal Syndrome , Epidemiology , IncidenceABSTRACT
Objective To investigate the pathogenesis of peripheral blood mononuclear cells(PBMC) nuclear factor kappa-?B(NF-?B) in children with primary nephritic syndrome(PNS) and the effect of astragalus on the activity of NF-?B.Methods Twenty-five children with PNS and 20 normal children were studied.Isolated PBMC were separated from 5 mL venous blood in asepsis condition.NF-?B stimulator,NF-?B inhabitor and astragalus were added into the different tubes of PBMC,respectively.The nuclear protein was extracted from the pellets and the optical density(A) values of nuclear protein was measured by enzyme-linked immunosorbent assay(ELISA).Results The activity of PBMC NF-?B in PNS group was higher than that in normal group(P0.05).Astragalus could decrease the activity of PBMC NF-?B which had been stimulated by interleukin-1?(IL-1?)(P
ABSTRACT
<p><b>OBJECTIVE</b>To discuss application of structural equation model (SEM) approach in epidemiological research.</p><p><b>METHODS</b>A brief overview on major components of SEM, statistical assumptions underlying the use of SEM, and current software available to users and how SEM can be used were discussed through a practical epidemiological research project.</p><p><b>RESULTS</b>Advantages of SEM comparing with conventional epidemiological approach were shown. SEM, having the nature of comprehensive thinking and analytic approach, not only exploring the association between factors and diseases but also among factors. It also served a confirmatory, rather than exploratory approach on data modeling, as well as having the capability of correcting estimates by separating measurement error from the equations, to provide modeling the latent variables.</p><p><b>CONCLUSION</b>SEM approach could be used in epidemiological research as having some advantages comparing with conventional epidemiological approaches.</p>
Subject(s)
Humans , Epidemiologic Methods , Epidemiology , Factor Analysis, Statistical , Models, Biological , Research DesignABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of neoadjuvant chemotherapy on estrogen receptor (ER) and progesterone receptor (PR) expression in breast carcinoma.</p><p><b>METHODS</b>Samples were obtained from 31 patients with breast carcinoma who received neo-adjuvant chemotherapy, ER or PR expressions were analyzed in preoperative core biopsies and final surgical specimens.</p><p><b>RESULTS</b>ER level was up-regulated in 13 (41.9%) out of 31 cases, PR level was up-regulated in 10 (32.3%). Both ER level and PR level were up-regulated in 8 (25.8%) out of 31 cases.</p><p><b>CONCLUSIONS</b>Neoadjuvant chemotherapy may impact the hormone receptor status, ER and PR expression re-analysis in final surgical specimens is recommended.</p>