ABSTRACT
<p><b>OBJECTIVE</b>To detect plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) in acute Kawasaki disease (KD) and analyze the relationship between NT-proBNP and other bio-markers in order to evaluate if NT-proBNP could be as a useful diagnostic marker to predict the risk of coronary arterial lesions in acute KD.</p><p><b>METHOD</b>Totally 106 patients with KD were recruited from January 2012 to April 2014 at Department of Pediatrics of Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology,64 were boys and 42 were girls, their age ranged from 2 months to 8 years and 4 months. Of the 106 cases, 48 had typical KD(TKD) and 58 incomplete KD(IKD). They were divided into two groups according to echocardiography results: coronary arterial lesions (KD-CAL, n = 33) and non coronary arterial lesions (KD-nCAL, n = 73). Forty children whose age and gender matched with respiratory tract infection were selected as control group, 22 were boys and 18 were girls, age range from 7 months to 7 years and 11 months. Plasma NT-proBNP levels were measured by using the enzyme-linked fluorescence analysis (ELFA) at the day of admission, meanwhile blood routine tests, liver function tests, determination of C-reactive protein (CEP), erythrocyte sedimentation rate (ESR), electrolytes were performed in these patients. Pearson's correlation analysis was used to evaluate the association. The ROC curve analysis was done to identify the threshold of coronary 'arterial lesions.</p><p><b>RESULT</b>The levels of NT-proBNP were (1 037 271) ng/L in TKD group and (1,325 ± 264) ng/L in IKD group. The levels of NT-proBNP in control group was (125 ± 22) ng/L. Both the levels of NT-proBNP in TKD and IKD group were significantly higher than that of control group (t = 3.360, 3.590; P < 0.05). The level of NT-proBNP in KD-CAL group was (2,775 ± 842) ng/L and that of KD-nCAL group was (830 ± 145) ng/L, NT-proBNP levels of KD-nCAL group was significantly higher than that of control group (t = 3.660, P = 0.007) ; moreover the level of NT-proBNP of KD-CAL group was also significantly higher than that of KD-nCAL group ( t = 3.860, P = 0.005). The levels of total white blood cell count, neutrophil percentage, platelet count, CRP and ESR of KD-CAL group were significantly higher than those of the control group, however there was no significant difference between KD-CAL group and KD-nCAL group. The levels of albumin and Na of KD-nCAL group were significantly lower than those of the control group. Plasma NT-proBNP level in KD group was positively correlated with white blood cell count, neutrophil percentage, and CRP (r = 0.239, P = 0.025; r = 0.359, P = 0.001; r = 0.474, P = 0.001), there was a negative correlation between albumin and Na (r = -0.303, P = 0.015; r = -0.338, P = 0.002). When the level of NT-proBNP was higher than 950 ng/L, the sensitivity for diagnosis of coronary arterial lesions in the KD was 88.1% and the specificity was 89.0%.</p><p><b>CONCLUSION</b>The plasma NT-proBNP can be used as a useful parameter in early diagnosis of KD. Plasma NT-proBNP could be used to predict the risk of coronary arterial lesions in KD.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Biomarkers , Blood Sedimentation , C-Reactive Protein , Case-Control Studies , Coronary Vessels , Pathology , Mucocutaneous Lymph Node Syndrome , Natriuretic Peptide, Brain , Blood , Peptide Fragments , Blood , Predictive Value of Tests , ROC Curve , Sensitivity and SpecificityABSTRACT
The effects of ghrelin on the proliferation and differentiation of 3T3-L1 preadipocytes and the possible mechanisms were investigated in this study.3T3-L1 preadipocytes were cultured in vitro and treated with different concentrations of ghrelin.Proliferation of 3T3-L1 preadipocytes was evaluated by MTT method and mRNA levels of c-myc and thymidine kinase were detected by RT-PCR.Morphological changes of 3T3-L1 preadipocytes were observed and cell differentiation was measured by oil red O staining.The mRNA levels of peroxisome proliferator-activated receptor γ (PPARγ) and CAAT/enhancer binding protein (C/EBPα) in the cells at different differentiation stages were detected by RT-PCR.The results showed that ghrelin at concentrations of 10-7 to 10-15 mol/L could significantly promote preadipocyte proliferation (P<0.05),with the most pronounced effect observed at 1011mol/L (P<0.01).Treatment of 3T3-L1 preadipocytes with ghrelin significantly in-creased the mRNA levels of c-myc and thymidine kinase (P<0.01).Morphological findings demonstrated that the great amount of lipid droplets appeared in the 3T3-L1 preadipocytes treated with ghrelin.Ghrelin could morphologically induce the differentiation of 3T3-L1 preadipocytes into mature adipocytes.Ghrelin significantly increased the mRNA levels of PPART and C/EBPα during the differentiation,when compared with control group (P<0.05).The mRNA levels of PPARγ and C/EBPα were obviously up-regulated with the differentiation of preadipocytes after the treatment of ghrelin.There were significant difference in the mRNA levels of PPARγ and C/EBPα on day 2 and day 8 of the differentiation of 3T3-L1 preadipocytes (P<0.01).In conclusion,ghrelin could promote the proliferation and differentiation of 3T3-L1 preadipocytes by increasing the mRNA levels of PPARγ and C/EBPα and therefore enhance the sensitivity of adipocytes against insulin.
ABSTRACT
The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical findings.Two-dimensional and real-time three dimensional echocardiography (RT3DE) was performed in 26 patients with atrial septal defect,and the echocardiographic data were compared with the surgical findings.Significant correlation was found between defect diameter by RT3DE and that measured during surgery (r=0.77,P<0.001).The defect area changed significantly during cardiac cycle.Percentage change in defect size during cardiac cycle ranged from 6%-70%.Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings.Therefore,RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.