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Objective:To screen and identify differentially expressed long non-coding RNA (lncRNAs) in peripheral blood of children with sepsis, and to explore the role of lncRNAs in the pathogenesis of sepsis in children.Methods:The peripheral blood samples of 3 children with sepsis admitted to the ICU of Children′s Hospital of Capital Institute of Pediatrics from January to December 2016 and 3 healthy children who underwent physical examination in our hospital during the same period were selected, and the differential expression profiles of lncRNAs and mRNAs were screened by lncRNAs sequencing technology.The target genes of differentially expressed lncRNAs were predicted and the relationship pairs of lncRNA-mRNA related to F 1F O-ATPase activity were constructed according to the results of GO analysis.Further increasing the sample size, we verified the expression of some F 1F O-ATPase activity-related mRNAs and lncRNAs which were differentially expressed in the screening results by real-time fluorescent quantitative polymerase chain reaction(qRT-PCR). Results:Sequencing results showed that there were 252 lncRNAs with significant differential expression in peripheral blood of children with sepsis compared with healthy children, of which 86 were up-regulated and 166 were down-regulated; meanwhile, there were 2 652 mRNAs with significant differential expression, of which 955 were up-regulated and 1 697 were down-regulated.The results of qRT-PCR showed that the expression of lncRNA ENST00000621933.1, ENST00000616950.1 and ENST00000595748.1 in peripheral blood of children with sepsis increased( P<0.05), while the expression of MT-ATP8, ATP5E and ENST00000624705.1, ENST00000615535.1 in peripheral blood of children with sepsis decreased( P<0.05), which was consistent with the sequencing results. Conclusion:lncRNAs are differentially expressed in peripheral blood of children with sepsis compared with healthy children.The expression levels of lncRNA ENST00000621933.1, ENST00000616950.1, ENST00000595748.1, ENST00000624705.1 and ENST00000615535.1 which their target genes are MT-ATP8 and ATP5E may be related to the development of sepsis in children.
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Objective@#To study the clinical characteristics of children with adenovirus pneumonia and provide evidence for clinical diagnosis and treatment timely.@*Method@#This retrospective study included 89 children who were confirmed to have adenovirus pneumonia in hospital from January 2015 to December 2016. All the immunofluorescence test result of the 89 children showed that the exfoliated nasopharyngeal cells from the 89 children were all adenovirus antigen positive. All the severe type children reached the diagnostic criteria of severe pneumonia by the respiratory group in the society of pediatrics, Chinese Medical Association. The children were divided into 2 groups (severe type group and common type group). Different factors such as epidemiologic feature, clinical manifestation, laboratory examination and imaging data were analyzed.@*Results@#Among the 89 pediatric patients, the male to female ratio was 1.5∶1. The ages ranged from 1 month to 14 years. Children under 5 years of age accounted for 96.6%(86/89). The incidence was 37.1%(33/89)in winter and 30.3%(27/89)in spring. The lengths of hospital stay were 3-48 days and the median length of stay was 8.25±4.75 days. All of these 89 cases had fever and cough. The proportion of severe adenovirus pneumonia was high among male, under 2 years of age, those with dyspnea, hepatosplenomegaly, tachycardia, leukocytosis, elevated C-reactive protein (CRP), PCT, myocardial enzymes, electrocardiogram abnormality and cluster shadow in chest CT. Differences were statistically significant (P<0.05).@*Conclusions@#Special attention should be paid to the male children under the 2 years of age with abnormal related indicators to consider severe adenovirus pneumonia. Early detection and treatment are the key to improve treatment and reduce death.
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Objective: To investigate the effects of high mobility group box-1 protein (HMGB1) exocrine promoted by G protein-coupled estrogen receptor (GPER) in cancer-associated fibroblast (CAF) combined with the small molecule compound G1 on the autophagy and proliferation of breast cancer MCF-7 cells. Methods: The GPER-shRNA lentiviral vector specifically interfering GPER gene expression was constructed and used to infect CAF (CAF-shGPER), while the CAF infected with a negative control lentivirus was used as the control (CAF-shNC). The expression levels of GPER mRNA and protein in CAF-shNC and CAF-shGPER cells were detected by real-time fluorescent quantitative PCR and Western blotting, respectively. The GPER-specific agonist G1 was used to treat the CAF-shNC and CAF-shGPER cells, respectively. Then the expression levels of HMGB1 mRNA and protein in CAF-shNC, CAF-shGPER, CAF-shNC+G1 and CAF-shGPER+G1 cells were detected by real-time fluorescent quantitative PCR and Western blotting, respectively. The secretion of HMGB1 protein in the conditioned medium of four groups was detected by enzyme-linked immunosorbent assay (ELISA). The conditioned medium of four groups was collected and used to treat MCF-7 cells. Then the expression levels of Beclin1, p62 and LC3 proteins in MCF-7 cells were detected by Western blotting, while the proliferation of MCF-7 cells was detected by CCK-8 assay. Results: After the lentivirus carrying GPER-shRNA was stably infected into CAF, the expressions of GPER mRNA and protein were significantly inhibited (both P<0.01). The expressions of HMGB1 mRNA and protein in CAF-shNC cells were significantly up-regulated by GPER specific agonist G1 (both P<0.05), while the secretion of HMGB1 was increased in the conditioned medium (P<0.05); However, the above effects of G1 were opposite in CAF-shGPER cells. Furthermore, the exocrine HMGB1 in conditioned medium up-regulated the expressions of Beclin1 and LC3 proteins (both P<0.01), down-regulated the expression of p62 protein (P<0.01), and increased the autophagy and proliferation abilities of MCF-7 cells (both P<0.01). Conclusion: The small molecule compound G1 can promote the expression of GPER in CAF in tumor microenvironment and increase the secretion of cytokine HMGB1, thus induce the autophagy of MCF-7 cells and promote the growth of MCF-7 cells.
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Objective To identify the diffusion alterations of deep gray matter(GM) and white matter (WM) among Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy people by atlas?based analysis (ABA), and to investigate the respective relationship with cognitive function. Methods Twenty?one AD patients (AD group), 8 MCI patients (MCI group) and 15 normal controls (control group) were performed by conventional MRI and diffusion tensor imaging (DTI). The raw data of DTI was processed by using DTI studio software to generate the fractional anisotropy (FA) images. Then ABA was used to quantify the FA value in 58 deep GM and WM structures. The differences of FA value among three groups were compared by using one way ANOVA, with a post?hoc analysis. In AD and MCI groups, the partial correlation was further investigated between mini?mental state examination (MMSE) score and FA value in the brain regions that have significant differences between AD and MCI group or between MCI and control group. Results Compared with control group, AD patients showed wide?spread FA decrease in most deep GM and WM regions (corrected P0.05). Conclusion Based on ABA, this study found the diffusion changes not only in the WM but also the deep GM in AD patients, but only WM diffusion disruptions in MCI group. The decreased FA value in the right SCC appeared early, but had no correlation with the cognitive impairment. The FA value in the hypothalamus, the fornix, the SLF and the cingulum decreased with the disease progression, and correlated positively with the cognition decline.
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Objective To investigate the clinical parameters,risk factors,treatment and clinical outcomes of pneumocystis pneumonia(PCP) in children without human immunodeficiency virus(HIV). Methods Retrospective a-nalysis was made for the clinical features,risk factors,treatment and prognoses of the non-HIV infected severe PCP pa-tients hospitalized at Pediatric Intensive Care Unit( PICU) of Children′s Hospital Affiliated to Capital Institute of Pedi-atrics. Results During April of 2010 to April of 2014,there were 10 cases of non-HIV infected severe PCP in PICU of Children′s Hospital Affiliated to Capital Institute of Pediatrics. All of the patients had predisposing diseases,in which 3 cases had connective tissue diseases,2 cases had acute leukemia,3 cases had severe pneumonia and 2 cases had con-genital immunodeficiency. The main clinical manifestations of those 10 patients were fever, cough, tachypnea and obvious dyspnea. All patients developed respiratory failure. The median value of Pediatric Critical Illness Score was 79. The median arterial oxygen pressure was 58 mmHg(1 mmHg=0. 133 kPa). The median oxygenation index was 103 mmHg. The median alveolo-arterial oxygen partial pressure difference was 43. 8 mmHg. The median CD4+T-lympho-cytes counts was 169 ×106/L. Eight patients on admission had mixed infection. Acute respiratory distress syndrome (ARDS) occurred in all of the patients,and 7 cases of them had multiple organ dysfunctions. All of the patients re-quired ventilation support. The median day for invasive mechanical ventilation days was 11 and the median day for non-invasive ventilation days was 6. The pneumothorax occurred in 5 patients. All patients received trimethoprim-Sulfame-thoxazole as initial therapy and Caspofungin treatment in combination in 7 cases of the patients. Six patients had nosoco-mial infection. The median time of PICU stay was 15. 5 days. Six patients survived and the mortality was 40%(4/10 cases) . Conclusions PCP is a kind of fatal diseases which occurred in patients with immunocompromised conditions and concurrent ARDS or multiple organ dysfunctions. Diagnostic suspicion and mechanical ventilation therapy with lung protective ventilation strategies may improve the clinical outcomes of non-HIV-infected PCP in children.
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The risk of death and chronic kidney disease will increase if severe patient development of acute kidney injury (AKI).International organizations in multiple disciplines of experts dedicated to the study early recognition and diagnosis AKI.And 3 new classification systems were recently developed in order to improve the ability of early diagnosing AKI.Sepsis is a common cause of pediatric hospital.It is also the most common cause of severe ill children developed AKI.Development of AKI during sepsis increases patient chronic kidney disease morbidity,predicts higher mortality.So it is crucial to early identify AKI to avoid delay in initiating renal protective and appropriate therapeutic measures.
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Objective To observe the formation of the biofilm in endotracheal tubes,the characteris-tics of etiology, drug resistance and relationship between the biofilm and ventilator-associated pneumonia ( VAP) . Methods A total of 60 cases of ventilated children patients whose mechanical ventilation time were≥48 h in the ICU from September 2010 to September 2012,according to the mechanical ventilation time,all cases were divided into 2 to 6 d group,7 to 14 d group and ≥15 d group. The incidence of VAP, biofilm structure under the electron microscope,etiology culture positive rate of the lower airway secretions and bio-film,etiological characteristics and drug resistance were prospectively studied. Results ( 1 ) A total of 19 cases occurred VAP in 60 cases of mechanical ventilation,the incidence of VAP was 31. 7%. (2) Observed by electron microscope,biofilm had formed in the endotracheal tube inner wall in early period of mechanical ventilation. With prolonged mechanical ventilation,biofilm structure had improved,as well as VAP incidence rate from 9. 1%(2 to 6 d group ) increased to 44. 4%(7 to 14 d group) and 88. 9%(≥15 d group). (3) A large number of pathogenic bacteria colonized in the biofilm. Gram-negative bacilli were dominate and drug resistance was high. (4) With prolonged mechanical ventilation,the cultured pathogens from the lower airway secretions and biofilm converged. Conclusion Biofilm could form in the endotracheal tube with mechanical ventilation patients,and is associated with the occurrence of VAP and refractory infections.