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Objective • To investigate the correlation between blood pressure and catecholamine levels in children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods • From January 2014 to December 2014, children and adolescents aged 2 to 12 years old who complained mainly of snoring during sleep were admitted to Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital and underwent surgery. Allnight polysomnography (PSG) was used to monitor and measure the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in conscious state. According to the blood pressure reference standard of Chinese children and adolescents in 2010, the children with OSAHS were divided into normal blood pressure group, SBP increased group, DBP increased group, and SBP and DBP increased group. The children with OSAHS were divided into light, moderate and severe OSAHS subgroups according to the apnea hypopnea index (AHI) and the lowest oxygen saturation (LSpO2). The correlation between blood pressure and the level of catecholamine was analyzed in the children with OSAHS. Results • Two hundred and twenty-three subjects were included in the analysis. The average SBP was (100.3±9.8) mmHg (1 mmHg=0.133 kPa) and the average DBP was (63.0±9.8) mmHg. There were 50 cases (22.42%) diagnosed as hypertension, in which 20 cases (8.97%) were severe hypertension. The 223 children with OSAHS were divided into mild OSAHS subgroup (n=59), moderate OSAHS subgroup (n=127) and severe OSAHS subgroup (n=37) according to OSAHS grades. The difference of adrenaline level between the normal blood pressure group and the DBP increased group was statistically significant (P=0.032). The difference of LSpO2 between the DBP increased group and the SBP and DBP increased group was statistically significant (P=0.031). There were no significant differences in dopamine and noradrenaline levels among the four groups. There were significant differences in SBP and adrenaline level between OSAHS mild subgroup and moderate subgroup (P=0.038, P=0.000), but there were no significant differences between the moderate OSAHS subgroup and the severe OSAHS subgroup. There were no significant differences in dopamine and noradrenaline levels among the three OSAHS subgroups. Conclusion • The increase of plasma catecholamine level in children with OSAHS can lead to the increase of SBP, which will increase with the development of OSAHS. Therefore, early diagnosis and treatment of OSAHS should be taken into consideration.
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Objective: To explore the inductive effect of galangin on HPV-positive human cervical cancer cells and the possible mechanism. Methods: Two HPV-positive human cervical cancer cell lines (SiHa cell and HeLa cell) and one HPV-negative human cervical cancer cell line (C-33-A cell) were given different concentration of galangin (20, 40, and 80 μmol/L) for 24, 48, and 72 h. Three human cervical cancer cell lines and relative cell viabilities were determined by the MTT method. Apoptosis and cell cycle were analyzed by flow cytometry. Western blotting analysis was used to determine the protein expression levels of Bcl-2 family proteins. Results: Cell proliferation of two HPV-positive human cervical cancer cells was significantly inhibited by galangin in a dose- and time-dependent manner, and galangin had no effect on cell proliferation of HPV-negative human cervical cancer cells. Cell cycle detection results showed that galangin could reversibly arrest the two HPV-positive cell lines, either in G1 or in G2/M phases. Flow cytometry results showed that beyond certain galangin concentration or/and over 24 h exposure, the cells underwent apoptosis. The data of Western blotting showed that 40 μmol/L galangin up-regulated the expression levels of Bad, Bid, and Bax, but down-regulated Bcl-2 and Bcl-w. Conclusion: Galangin can inhibit the proliferation of HPV-positive cervical cancer cells and promote apoptosis, which may be associated with the regulation of Bcl-2 family proteins expression.
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Objective To report a peliosis hepatic in child and review literature and discuss.Methods Case history was inquired.Physical,labtoratory,imagement and histopathology of liver biopsy(HE staining) were examed.Results A 4-year old girl appeared dermatitis with erythema and herpes at local skin where was bit by insect before onset.The girl appeared fever,cough,then abdominal pain,hepatomegaly,pleural effusion and ascites.Lab examination revealed slight elevation of aspartate transaminase,?-glutamyltranspeptidase and alkaline phosphatase.The liver B-mode ultrasonography and CT scan revealed hepatomegaly with density heterogeneity of the parenchyma.The liver biopsy revealed many small capsule filled with blood cells.Conclusions Clinical characteristics of the disease are fever,upper abdomen pain,janundice,ascites and hepatomegaly.The diagnosis shall be combined with the pathologic biopsy of liver.
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<p><b>OBJECTIVE</b>Idiopathic collapsing glomerulopathy (ICG) is a clinically and pathologically distinct variant of focal segmental glomerulosclerosis, which is characterized by proteinuria (often nephrotic range) and rapid progression to end-stage renal failure. The typical pathological changes are global/segmental glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. Most ICG patients who have been reported in previous published papers are adults. ICG in children is rare. The study aimed to analyze and investigate clinical manifestations, renal histopathological findings, treatment and outcomes of ICG in children.</p><p><b>METHODS</b>Data of two cases of ICG, a 7-year-old boy and a 12-year-old girl, were analyzed. Both of them were Chinese and Han. Clinical characteristics, results of laboratory tests, renal histopathological findings, treatment, outcomes and prognosis of the two children with ICG were retrospectively analyzed. Results were compared with published data.</p><p><b>RESULTS</b>These two children presented typical clinical features of nephrotic syndrome. The quantity of 24 hr urine protein was 7.6 g/d (0.47 g/kg x d for boy) and 10.67 g/d (0.35 g/kg x d for girl). Both of them had hypertension (blood pressure ranged from 130/90 to 150/110 mmHg) and hypercholesterolemia (15.4 mmol/L for the boy and 11.3 mmol/L for the girl). The serum albumin was 12 g/L for girl and 23 g/L for boy. The creatinine clearance rate gradually decreased from normal range to 30 ml/min for the girl. The histopathological changes in renal biopsy of them were focal segmental or global glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. These two cases were steroid-resistant and were treated with pulse intravenous methylprednisolone and pulse intravenous cyclphosphamade in one case, who rapidly progressed to end-stage renal failure and died half a year later. Another one was treated with cyclosporine. He showed continuous hypertention and heavy proteinuria for eight months.</p><p><b>CONCLUSION</b>ICG in the 2 children was a severe disease which presented steroid-resistant nephrotic syndrome and rapidly progressive renal failure. The pathological characteristics was global/segmental glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. In children with ICG treatment was difficult and the prognosis was poor.</p>
Subject(s)
Child , Female , Humans , Male , Disease Progression , Glomerulosclerosis, Focal Segmental , Diagnosis , Pathology , Therapeutics , Glucosinolates , Kidney , Pathology , Kidney Failure, Chronic , Kidney Glomerulus , Pathology , Nephrotic Syndrome , Proteinuria , Treatment OutcomeABSTRACT
Objective To analyze the clinical features of immunoglobulin A(IgA) nephropathy(IgAN) occurring in the context of pre-vious acute glomerulonephritis.Methods The clinicopathologic features of 108 cases(77 males,31 females,aged 3.2 to 14.0 years old) of IgAN were analyzed restrospectively with the onset of acute glomerulonephritis in this department from Jan.1994 to Dec.2005.Results Of 108 cases with IgAN,10 cases were with the onset of acute glomerulonephritis. All the 10 cases presented with edema, hematuria and proteinuria.Eight cases had macroscopic hematuria, lasting for 2 days to 2 months.Four cases had recurrent macroscopic hematuria,microscopic hematuria lasting for 16 months.Urine protein qualitative +-+++ lasted for 1-8 months.Two cases had hypertension;2 cases had increasing blood uria nitrogen and serum creatinine.The increase of anti-streptolysin O(ASO) titer was detected in 5 of 9 cases.Two cases had a high titer of DNase-B antibody, and 4 cases had hypocomplementemia.Eight cases had prodromal infection with an interval time varying from 1 to 5 days.Renal biopsies revealed mesangial proliferative glomerulonephritis in 9 cases and focal segmental glomerulosclerosis in 1 case, all with mesan-gial IgA deposition.Conclusions The interval time between the prodromal infection and nephritis symptoms is mostly short in IgAN with the onset of acute glomerulonephritis, while macroscopic and microscopic hematuria remain a fairly long time or recurrently aggravate. Renal biopsy is necessary to diagnose IgAN for this kind of children.