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Objective:To compare the clinical characteristics, clinical efficacy and adverse drug reactions of rheumatoid factor (RF) positive (+ ) and negative (-) polyarticular juvenile idiopathic arthritis (PJIA).Methods:The clinical data of 67 PJIA patients admitted into Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2013 to December 2018 were analyzed retrospectively.They were divided into RF-positive PJIA group [RF (+ ) group, 23 cases] and RF-negative PJIA group [RF (-) group, 44 cases] according to RF titer.The clinical characteristics, laboratory indexes and clinical efficacy evaluation of the two groups were compared.Results:(1)Distribution of affected joints: the top 3 affected joints in the RF (+ ) group were the knuckles (16 cases, 69.57%), the wrists (15 cases, 65.22%) and the ankles (13 cases, 56.52%), and those in the RF (-) group were the knees (33 cases, 75.00%), ankle joints (29 cases, 65.91%) and hip joints (26 cases, 59.09%). The wrist joint involvement of the RF (+ ) group was significantly higher than that of the RF (-) group, while the knee joint involvement was lower than that of the RF (-) group.The difference was statistically significant (all P<0.01). (2)Magnetic resonance changes of the affected joints: articular cavity effusion (54 cases, 84.38%), synovial thickening (44 cases, 68.75%) and bone edema (26 cases, 40.63%) are common in both groups.The incidence of bone destruction (7 cases, 70.00%) and soft tissue edema (7 cases, 70.00%) in the RF (+ ) group was higher than that in the RF (-) group (2 cases, 18.18% and 2 cases, 18.18%), the difference was statistically significant (all P<0.05). (3) Changes in laboratory indicators: the positive rates of C-reactive protein, erythrocyte sedimentation rate, anti-cyclic citrullinated peptide antibody and anti-nuclear antibody in the RF(+ ) group were significantly higher than those in the RF(-) group, the difference was statistically significant (all P<0.05). (4)Juvenile arthritis disease activity score 27 (JADAS27): the score difference between RF(+ ) group and RF(-) group was not statistically significant [(22.83±5.60) scores vs.(23.07±6.66) scores, t=0.148, P>0.05]. (5) Efficacy analysis: 2 patients were lost to follow-up after discharge, and the remaining 65 patients were treated with traditional therapy, of which 30 were given biologics at the first hospitalization, 9 cases were treated with biologics after the failure of traditional treatments, and 35 patients were treated with biologics to control disease activity.In different dosage regimens, the disease remission rate in the RF(-) group is generally higher than that in the RF(+ ) group. Conclusions:PJIA patients have complicated joint involvement, RF-positive patients are more prone to joint destruction, and traditional treatments are less effective.Biological agents can effectively improve the symptoms of severe PJIA patients, especially those with poor prognosis.
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Hospital culture is a powerful motivation to promote the sustaining development of hospital. Cheng-de central hospital got into trouble once because ideology and management idea was difficult to change, and the new leadership timely adjusted concept and scientifically planned discipline construction and development;meanwhile, We actively implement a new developing strategy of invigorating the hospital through culture,and gradually construct a hospital culture focusing on the spiritual and physical status of the medical staff that is beneficial to the hospital development. forming a new co-prosperity situation of hospital culture and hospital development.
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Objective To detect serum interleukin 6(IL-6), N-terminal pro-brain natriuretic peptide (NT-proBNP) and serum ferritin in acute Kawasaki disease (KD), and explore their values in the diagnosis of KD, and further to explore the relationship with intravenous immunoglobulin (IVIG) unresponsiveness and coronary arterial lesions (CALs). Methods Totally 108 patients with KD (81 IVIG responders and 27 IVIG non-responders, 31with CALs and 77 non-CALs) were recruited from October 2014 to February 2016 at Department of Pediatrics of Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, 64 were boys and 44 were girls. Their ages ranged from 2 months to 11 years and 5 months. A total of 30 children with respiratory tract infection were selected as the control group, 18 were boys and 12 were girls, ages ranged from 4 months to 10 years. Serum IL-6, NT-proBNP and serum ferritin were measured at the day of admission. The differences between groups were analyzed by t-test. To compare the power of serum level of interleukin 6(IL-6), N-terminal pro-brain natriuretic peptide (NT-proBNP) and serum ferritin levels in predicting KD, IVIG unresponsiveness and CALs, receiver-operating characteristic (ROC) curves were plotted and areas under the curve (AUC) were calculated. All data are presented as means ± standard deviation. Results (1) The levels of IL-6 135 ± 268ng /L, NT-proBNP 1008 ± 1675ng /L and ferritin 227 ± 238μg /L were significantly higher in the acute phase patients with KD than those of the control group 27 ± 29ng /L for IL-6 (t = 2. 192, P = 0. 03), 109 ± 100ng /L for NT-proBNP(t = 5. 463, P = 0. 000) and 72 ± 101μg /L for ferritin (t = 3. 437, P = 0. 001). (2) The levels of NT-proBNP 1837 ± 2666ng /L in IVIG unresponsive group were significantly higher than those of the IVIG responsive group 720 ± 1032ng /L (t = 3. 108, P = 0. 002). However, there were no significant difference of IL-6 and serum ferritin between the two groups. (3) The levels of NT-proBNP in CALs group 1703 ± 2569ng /L vs 742 ± 1080ng /L, serum ferritin 340 ± 405μg /L vs 183 ± 99μg /L were significantly higher than those of the non-CALs group (P ＜ 0. 05). However, there was no significant difference of IL-6 between the two groups. (4) The area under the curve for predicting KD with various variables were as follows: serum IL-6 0. 773, NT-proBNP 0. 835 and serum ferritin 0. 793. The area under the curve for predicting resistance to IVIG with serum NT-proBNP was 0. 623. The area under the curve for predicting CALs with various variables were as follows: NT-proBNP 0. 612 and ferritin 0. 671. The ROC of ferritin for predicting CALs is better than NT-proBNP. A ferritin cut-off value of 160. 2μg /L yielded a sensitivity of 73. 7％, specificity of 52. 1％. Conclusion The serum IL-6, NT-proBNP and serum ferritin can be used as useful parameters in early diagnosis of KD. Elevated NT-proBNP or serum ferritin may be useful to predict IVIG resistance and CALs in KD patients.
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Diabetes secondary to pancreatic exocrine insufficiency is commonly referred to as pancreatogenic diabetes or type 3c diabetes.Among all diabetic patients in the western population,the prevalence of type 3c diabetes is about 5%-10%,but some patients with pancreatogenic diabetes are misdiagnosed as type 2 diabetes.So far,researches on pancreatogenic diabetes are being explored.The definition,diagnosis,prevalence,pathogenesis,clinical features and treatment status of pancreatogenic diabetes are described and analyzed in this paper.
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Kawasaki disease(KD) is an acute,self-limited vasculitis of childhood and has become the leading cause of acquired pediatric heart disease.The underlying etiology remains unknown.The disease itself may be the characteristic manifestation of a common pathway of immune-mediated vascular inflammation in susceptible hosts.Intravenous immunoglobulin (IVIG) is now widely accepted as the first-line therapy for KD.However,approximately 10％-20％ of patients are resistant to IVIG.Although,an additional administration of IVIG is often chosen for the treatment of KD patients resistant to the first administration of IVIG,its efficacy is reported to be lower than that of the first IVIG dose.Thus,it is clear that some KD patients can not be treated successfully by IVIG alone,even if it is used repetitively.Currently,methylprednisolone(MP) is used for the treatment of IVIG-resistant KD.However,the proper use of MP for maximum effect and safety has not yet been elucidated.Tumor necrosis factor-α blocker,infliximab effective in the control of inflammation in patients with resistant KD.Cyclosporin treatment is also a promising option for patients with refractory KD.Plasma exchange was a safe,effective prophylactic measure against coronary artery lesions in children with KD refractory to intravenous gamma globulin therapy.
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Tocilizumab is a recombinant humanized monoclonal antibody against interleukin(IL)- 6 receptor (IL - 6R). It can prevent IL - 6 from binding to membrane - bound or soluble IL - 6R,thus blocking IL - 6 mediated signal transduction,and clinically alleviating inflammation and joint destruction in rheumatoid arthritis(RA). Both in the American and European Union,intravenous Tocilizumab has been approved for the treatment of both systemic juve-nile idiopathic arthritis(sJIA)and polyarticular JIA(pJIA)in patients aged ﹥ 2 years old. The approval was based on the favorable results from 2 randomized,double - blind,placebo - controlled,multinational,phase Ⅲ trials conducted in patients aged 2 - 17 years old with active sJIA or pJIA. Tocilizumab was generally well tolerated in patients with sJIA and pJIA. The most frequently reported adverse events in Tocilizumab recipients were infections,neutropenia,impaired liver function,etc.
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Objective To analyze the spectrum of underlying diseases in children with transient loss of consciousness (TLOC) through a multi-center and large sample clinical research.Methods Nine hundred and thirty-seven children with TLOC who came from Beijing,Hunan province,Hubei province and Shanghai of China from Aug 1999 to Apr 2011 were recruited in the present study,and then the spectrum of underlying diseases in children with TLOC was analyzed.Results In 937 children with TLOC,903 cases (96.4％ )were children with syncope,34 cases (3.6％) were non-syncope.And in 903 children with syncope,213 cases (23.6％) had vasovagal syncope (VVS) with vasoinhibitory response,46 cases (5.1％ ) had VVS with cardioinhibitory response,112 cases ( 12.4％ ) had VVS with mixed response,268 cases (29.7％ ) had postural tachycardia syndrome,22 cases (2.4％) had orthostatic hypotension,19 cases (2.1％ ) had situational syncope,21 cases (2.3％ ) had cardiogenic syncope,and 202 cases (22.4％ ) had unexplained syncope.Conclusion In children with TLOC,syncope was the most common underlying disease.And in children with syncope,the most common was VVS,followed by postural tachycardia syndrome.In three different hemodynamic patterns of VVS,the most common pattern was VVS vasoinhibitory pattern.
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AIM: To evaluate the potential acylation stimulating protein (ASP) resistance in both adipocytes and preadipocytes under the conditions by which insulin resistance is produced by the stimulation of free fatty acids (FFA), and to explore the mechanism of ASP resistance on post-receptor level. METHODS: 3T3-L1 preadipocytes were induced to differentiate. Then the cells were treated with oleate or palmitate at concentration of 0 mmol/L (FFA-free DMEM/F12), 0.125 mmol/L, 0.5 mmol/L or 1.0 mmol/L overnight. Glucose transport was assessed by [~3H] 2-deoxyglucose uptake to evaluate insulin resistance and ASP resistance. Both non-FFA treated and FFA treated 3T3-L1 cells were cultured with ASP at concentration of 5.0 μmol/L for 4 h, then the cell proteins were extracted, and the expressions of guanine nucleotide binding protein beta (Gβ), guanine nucleotide-binding protein alpha-q/11(Gαq/11), phosphorylated-protein kinase Cα (p-PKCα) and phosphorylated-protein kinase Cζ (p-PKCζ) were measured by Western blotting. RESULTS: Both adipocytes and preadipocytes were responsive to ASP. ASP stimulation increased glucose transport by 198% in adipocytes and by 287% in preadipocytes (P<0.01 vs PBS). FFA at concentration of 0.125 mmol/L did not change ASP-stimulated glucose transport significantly, but high dose of oleate or palmitate effectively reduced the ASP response with a significant reduction by 47% (P<0.05 for oleate) and 34% (P<0.05 for palmitate) at 1 mmol/L FFA in adipocytes. Similarly in preadipocytes, glucose uptake rates were decreased by 43% (P<0.05 for oleate) and 62% (P<0.01 for palmitate) at 1 mmol/L FFA. Effects were comparable to those obtained with insulin. After overnight incubation with oleate or palmitate in adipocytes and preadipocytes, Gβ, Gαq/11, p-PKCα and p-PKCζ were downregulated both in the absence of ASP treatment and in the presence of ASP treatment in adipocytes. At concentration of 1.0 mmol/L, oleate inhibited the expressions of ASP-induced Gβ, Gαq/11, p-PKCα and p-PKCζ in adipocytes by 47%, 44%, 39% (P<0.05, P<0.01) and 20% (P>0.05), respectively. Palmitate also effectively blocked the expressions of ASP (at concentration of 1.0 mmol/L)-induced Gβ, Gαq/11, p-PKCα and p-PKCζ by 50%, 43%, 44% and 43% (P<0.05, P<0.01) in adipocytes. In preadipocytes, oleate only inhibited ASP-induced p-PKCα and p-PKCζ significantly by 39% and 19%, respectively (P<0.05). However, overnight exposure of 3T3-L1 preadipocytes to 1 mmol/L palmitate leaded to 45%, 50%, 52% and 21% (P<0.05, P<0.01) inhibition of ASP-induced expressions of Gβ, Gαq/11, p-PKCα and p-PKCζ, respectively. CONCLUSION: Oleate and palmitate inhibit ASP-mediated stimulation of glucose transport both in adipocytes and preadipocytes. The study provides direct evidence of ASP resistance under the condition of insulin resistance induced by FFA in a cellular model. The mechanism of action involves both changes in expression of C5L2 as well as signaling parameters. Fatty acid-induced ASP resistance may contribute to the physiological abnormalities associated with insulin resistance and obesity phenotype.
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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.
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Young Adult , Echocardiography, Three-Dimensional , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Atrial/pathology , Heart Septal Defects, Atrial/surgeryABSTRACT
The non-neuronal cholinergic system, widely exists in prokaryotic, eukarytic, and even plant cells, however, it has not been investigated in preadipocytes and adipocytes. To search for evidence its existence in preadipocytes and adipocytes, the nicotinic acetylcholine receptor (nAChR) α7 subunit, acetyicholinesterase (ACHE) and choline acetyltransferase (CHAT) in 3T3-L1 cells were examined using immunohistochemical staining and Western blotting. The choline-regulated visfatin expression in 3T3-L1 preadipocytes was also tested by reverse transcriptase-PCR. Incubation with methyilycaconitine (10-6 to 10-4mol/L) for 12, 24 and 36 hours dose-dependently increased visfatin expression from 1.3- to 1.55-folds (P <0.01) with maximal induction at 24 hours with 10-4mol/L methyllycaconitine. Nicotine treatments (10-6 to 10-4 mol/L) for 12, 24 and 36 hours decreased visfatin expression; choline chloride (10-4 mol/L))suppressed visfatin expression in 3T3-L1 preadipocytes at 36 hours by 1.64 to 2.03 fold (P < 0.05) which was more effective as compared with nicotine. It was concluded that α7 nAChR was expressed in 3T3-L1 preadipocytes and involved in visfatin expression.
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In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients' medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraoperative assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macroscopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girts (male: female=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aortic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve malformation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases,10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aortic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic disease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical information, echocardiographic findings and operative details were important in evaluating the etiology of aortic valve disease.
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In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients' medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraoperative assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macroscopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girls (male: female=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aortic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve malformation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases, 10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aortic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic disease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical information, echocardiographic findings and operative details were important in evaluating the etiology of aortic valve disease.
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AIM: To investigate whether there was nicotinic acetylcholine receptor subunit α 7 (nAChR α 7 ), choline acetyltransferase(ChAT), acetylcholinesterase(AChE) expression and its regulation in mature dendritic cells (DCs). METHODS: Bone marrow(BM) -derived DCs from healthy BALB/c mice were incubated with rmGM -CSF and rmIL-4, and stimulated to mature with LPS. Meanwhile, light microscope and flow cytometry were used to identify DCs, as well as immunocytochemistry, immunofluorescence, flow cytometry and RT - PCR methods were used to dectect expression of nAChR α 7, ChAT and AChE. Flow cytometry was also used to analyze nAChR α 7 expression with mecamylamine (MEC) in 12 h. RESULTS: Both protein and mRNA expression of cholinergic system nAChR α 7, ChAT and AChE were found in mature DCs. Furthermore, nAChR α 7 distributed principally in cell membrane, while ChAT and AChE in cytoplasm. Protein expression of AChE was stronger as compared with ChAT ( P ＜ 0. 05), and there was a trend toward increasing as compared with nAChR α 7. And then, the expression of nAChR α 7 was down regulated by MEC as compared with the group without MEC stimulation(P ＜ 0. 05 ). CONCLUSION: An innate cholinergic system was in mature DCs, which was affected by extrinsic factor ( i. e. , MEC). And it may be involved in anti - inflammation immune adjustion of cholinergic closed - circuit.
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To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide given by intracerebroventricular (icv) injection. The third ventricles were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later, acute gastric lumen perfusion was carried out. The gastric perfusion samples were collected every 10 min and were titrated by 0.01 mol/L NaOH to neuter. On the basis of subcutaneous injection of pentagastrin (G-5, 160 micro, g/kg), icv injection of physiological saline (group A, n = 20), icv injection of octreotide (0.05 micro g) (group B, n = 20), icv injection of naloxone (2.5 micro g)+octreotide (0.05 micro g) (group C, n = 20), acute subdiaphragmatic vagotomy+ icv injection of physiological saline (group D, n = 20), or acute subdiaphragmatic vagotomy+icv injection of octreotide (0.05 micro g) (group E, n = 20) were conducted. Before and after icv injection, 1-h total acid output (TAO) was determined and compared. The experimental data were expressed in change rate (%) of TAO. The change rates (%) of TAO were 4.60% in group A, -20.35% in group B, -18.06% in group C, 5.01% in group D and -21.59% in group E, respectively. Comparison of group B or C versus group A showed that P 0.05 for all). The results indicate that the central inhibition of gastric acid secretion by octreotide may not be mediated by the endogenous opiate substance or its receptor and the peripheral pathway for icv injection of octreotide to suppress gastric acid secretion is via extra-vagus route.
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To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide given by intracerebroventricular (icv) injection. The third ventricles were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later, acute gastric lumen perfusion was carried out. The gastric perfusion samples were collected every 10 min and were fitrated by 0.01 mol/L NaOH to neuter. On the basis of subcutaneous injection of pentagastrin (G-5, 160 μ g/kg), icv injection of physiological saline (group A, n=20), icv injection of octreotide (0.05 μ g)(group B, n=20), icv injection of naloxone (2.5 μ g)+octreotide (0.05 μ g) (group C, n=20), acute subdiaphragmatic vagotomy+ icv injection of physiological saline (group D, n=20), or acute subdiaphragmatic vagotomy+icv injection of octreotide (0.05 μ g) (group E, n=20) were conducted. Before and after icy injection, 1-h total acid output (TAO) was determined and compared. The experimental data were expressed in change rate (%) of TAO. The change rates (%) of TAO were 4.60 % in group A, -20.35 % in group B, -18.06 % in group C, 5.01% in group D and -21.59 % in group E, respectively. Comparison of group B or C versus group A showed that P＜0.01 and comparison between the group E versus group D showed that P＜0.01. Whereas the differences between group C and group B, group E and group B were not statistically significant (P＞0.05 for all). The results indicate that the central inhibition of gastric acid secretion by octreotide may not be mediated by the endogenous opiate substance or its receptor and the peripheral pathway for icv injection of octreotide to suppress gastric acid secretion is via extra-vagus route.
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Objective To investigate the effect of different sex hormones on insulin-stimulated glucose uptake on cultrured 3T3-L1 preadipocytes and adipocytes.Methods We treated cultured 3T3-L1 preadipocytes and adipocytes with different concentrations of 17?-Estradiol or testosterone and the effects were assessed as 2-deoxy glucose uptake.Results After incubation with 17?-Estradiol or testosterone,the ability of insulin-stimulated glucose transport was statistically significantly reduced.Dosage response study demonstrated that(10~(-7) mol/L) testosterone or(10~(-8) mol/L) 17?-Estradiol can induce insulin resistance(P
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Summary: In order to objectively evaluate the efficacy of intravenous gammaglobulin (IVIG) in the prevention and treatment of coronary artery lesion (CAL) in Kawasaki disease (KD) and the related factors influencing the IVIG efficacy, 314 children with KD were reviewed retrospectively and comparatively and were divided into IVIG plus aspirin group and ASA group. The occurrence and restoration of CAL in these two groups as well as many laboratory and clinical indexes including average hospital stay (days), total fever duration, defervescence time, platelet count, erythrocyte sedimentation rate, C reactive protein etc. were observed. The incidence of CAL was 39.5 % in the children with KD. In the IVIG+ASA group, the incidence of CAL was 34.3 % and 56.0 % in ASA group respectively (P<0.001). The incidence of CAL was reduced in the group in which 2.0 g/kg or 1.0 g/kg IVIG was administered as compared with the group in which IVIG was administered at a dose ≤0.6 g/kg or ≥3.0 g/kg (P<0.05). CAL occurred less frequently when IVIG was administered at 3-10 days of the course than that when IVIG was administered ≤3 days or >10 days (P<0.05). About 13.4 % of the CAL treated with IVIG was not recovered at the 12 th month of the course, mostly in the groups in which only ASA was administered and IVIG treatment was started 10 days later. The hospital stay (days), defervescence time, total fever duration, platelet count, erythrocyte sedimentation rate and C reactive protein were significantly reduced in IVIG+ASA group as compared with those in the ASA group (P<0.05). IVIG treatment can remarkably shorten the course of patients with KD and decrease the incidence of CAL, but the efficacy of IVIG in the prevention and treatment of KD disease is not as expected by people, therefore, reevaluation of the practical efficacy of IVIG is required.
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AIM: The purpose of the present study was to examine the effect of insulin and different kinds of free fatty acid (FFA) on glucose transport in cultured 3T3-L1 preadipocytes or adipocytes. METHODS: Following the exposure of preadipocytes to insulin at different concentrations and treated times, glucose transport was assessed as [3H]2-deoxy glucose uptake. Furthermore, 3T3-L1 preadipocytes and adipocytes with either the monounsaturated FFA oleate (C18:1) or the saturated FFA palmitate (C16:0)were used and glucose transport was examined as above. RESULTS: Insulin increased specific membrane glucose transport in 3T3-L1 preadipocytes at the time of 15 min to 1 h stimulation. However, after 6 h exposure to insulin, downregulation of glucose transport was observed. Dose response studies demonstrated that 2-DG transport increased by 336% at 50 nmol/L of insulin (P