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Objective:To evaluate the hemodynamic changes and short-term (one year) outcomes after superficial temporal artery(STA)-middle cerebral artery (MCA) bypass by vascular ultrasonography.Methods:Operation group included a total of 41 hemispheres of 38 patients who underwent STA-MCA bypass for severe stenosis or occlusion of MCA or severe stenosis or occlusion of internal carotid artery(ICA), or Moyamoya disease at Xuanwu Hospital between August 2017 and June 2020. The following examinations were performed in all patients: cranial MRI, CT perfusion imaging, and cerebral angiography. All of the patients were retrospectively followed up for one year postsurgery. Normal group included a total of 40 hemispheres of 20 healthy people who had been examined by vascular ultrasonography of carotid artery and intracranial artery. Inner diameter, peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), resistance index (RI), pulsatility index (PI) and flow of STA, PSV, EDV, MV, PI, RI of external carotid artery (ECA) and PSV, EDV, MV, PI, RI of MCA at 1 week, 6 months and 12 months after STA-MCA bypass of operation group were compared with normal group.Results:①Inner diameter, PSV, MV and flow of STA were increased significantly in operation group at 1 week, 6 and 12 months than normal group (all P<0.05). The flow of STA was decreased significantly from 1 week to 12 months after operation (all P<0.05), but Inner diameter, PSV and MV were only decreased gradually from 1 week to 12 months after operation (all P>0.05). ②STA/ECA PI and RI decreased significantly after operation compared with normal group (all P<0.01). Conclusions:Vascular ultrasonography is a non-invasive examination which can objectively evaluate the extracranial and intracranial hemodynamic changes after STA-MCA bypass, and provide reference effectiveness of the operation. The flow of STA has decreased gradually from 1 week to 12 months after operation to achieve the homeostasis, but it is still higher than normal.STA/ECA PI and RI can be a steady indirect pointer to show the fluency of bypass.
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Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.
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Objective:To analyze the association between the perioperative amplitude-integrated electroencephalogram(aEEG)of neonates with congenital heart disease(CHD) and their neurodevelopmental outcome at 2 years of age.Methods:Neonates with CHD ( n=32) who were admitted to the neonatal intensive care unit at our hospital were included.All patients had undergone cardiac surgery during the neonatal period and preoperative and postoperative aEEG monitoring.The background pattern, sleep-wake cycle(SWC) pattern and seizure activity (including electrographic seizure activity) were used to quantify cerebral activity related to brain function.Infants with CHD were enrolled prospectively to follow up at 2 years old.Participants were assessed at 2 years old via the Bayley Scale of Infant Development. Results:A total of 32 neonates were enrolled in the study.Compared with average of normal population, psychomotor development index(PDI) of participants decreased significantly ( P<0.05). The mental development index(MDI) of patients with abnormal behavior was significantly lower.The longer length of ICU, longer time of ventilation, and the older age of father were risk factors of lower PDI.The MDI (76.29±23.38) of cases with mild abnormal preoperative background pattern were significantly lower than that with normal background pattern (97.37±22.65)( P=0.039). The PDI (74.00±20.09) of cases with abnormal preoperative background pattern was significantly lower than that (92.12±20.42) with normal preoperative background pattern ( P=0.046). The PDI (85.04±20.384) of cases with immature preoperative SWC were significantly lower than that with the normal preoperative SWC(110.00±16.55) ( P=0.027). Conclusion:Abnormal perioperative background pattern and SWC are markers for neurodevelopment disorder.The perioperative aEEG is a useful bedside tool that helps predict outcomes in infants underwent heart surgery.
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Background Acute exposure to mercury chloride (HgCl2) can cause liver damage. Whether oleanolic acid (OA) as a hepatoprotective drug can protect against liver injury induced by acute exposure to HgCl2 and related mechanism of action remain unclear. Objective To investigate the protective effect and possible mechanism of OA on liver injury in mice caused by acute exposure to HgCl2. Methods Forty SPF C57BL/6 male mice were randomly divided into four groups with 10 mice in each group according to body weight. The four groups were named control group, OA group (300 mg·kg−1), HgCl2 group (5 mg·kg−1), and OA + HgCl2 group (300 mg·kg−1 OA + 5mg·kg−1 Hgcl2). Soybean oil and OA solution were administered intragastric once a day for two consecutive days. HgCl2 solution was injected intraperitoneally 2 h after the second intragastric administration. Mice were sacrificed after 48 h, and their serum and liver were collected. Liver coefficient was calculated. The changes of liver structure and iron deposition were observed by hematoxylin-eosin (HE) staining and Prussian blue staining. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total superoxide dismutase (T-SOD), reduced glutathione (GSH), malondialdehyde (MDA), and tissue iron content were measured with commercial kits. Western blotting was used to detect nuclear factor erythroid-2 related factor 2 (Nrf2), heme oxygenase 1 (HO-1), glutathione peroxidase 4 (Gpx4), transferrin receptor 1 (TFR1,) and solute carrier family 7 member 11 (SLC7A11). Results The AST and ALT levels of the HgCl2 group were (76.447±9.695) U·g−1 and (98.563±24.673)U·g−1, respectively, which were higher than those of the control group (P<0.05). After the OA pretreatment, the liver coefficient and the above indexes were decreased to (4.769±0.237)%, (57.086±10.087) U·g−1, and (87.294±27.181)U·g−1, respectively. The liver coefficient and AST level of the OA + HgCl2 group were significantly different from those of the HgCl2 group (P<0.05). After acute exposure to HgCl2, the hepatocytes of mice were disordered, accompanied by inflammatory infiltration, positive blue particles appeared in Prussian blue staining of liver tissue, and the above changes in liver tissue were alleviated after the OA pretreatment. The iron content in the HgCl2 group was (3.646±0.238) μmol·g−1, which was higher than that in the control group, (2.948±0.308) μmol·g−1. After the OA pretreatment, the iron content decreased to (3.429±0.415) μmol·g−1. Compared with the control group, acute exposure to HgCl2 resulted in decreased levels of GSH and T-SOD, decreased protein expression levels of Nrf2, HO-1, SLC7A11, and Gpx4, increased level of MDA, and increased protein expression level of TFR1 (P<0.05). After the OA pretreatment, all indicators were improved including increased GSH level, decreased MDA level, increased Nrf2, HO-1, and SLC7A11 protein expression levels, and decreased TFR1 protein expression level; compared with the HgCl2 group, the differences were statistically significant (P<0.05). Conclusion Acute HgCl2 exposure could induce liver injury in mice, and its mechanism may involve iron overload and ferroptosis. OA may alleviate the liver injury caused by acute HgCl2 exposure by affecting iron overload and the ferroptosis-related protein expression.
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Objective:To explore the cause and treatment of chylothorax after surgery for congenital heart disease(CHD) in newborns.Methods:A retrospective analysis was made to the clinical data of 49 newborns with chylothorax after surgery for CHD within the period from January 2009 to December 2019. These newborns were aged from from 1 day to 28 days with the weight from 2.0 kg to 4.1 kg. The complete transposition of great arteries was performed in 13 cases, coarctation of the aorta/ interruption of the aortic arch in 13 case, right ventricular outflow tract reconstruction/ Blalock-Taussing shunt in 9 cases, total anomalous pulmonary venous connection in 8 cases, ventricular septal defect repair and atrial septal defect repair in 4 cases, ligation of patent ductus arteriosus in 1 case and persisten truncus arteriosus in 1 case. Chylothorax occurred in the right in 19 cases, left side in 20 cases, bilateral in 9 cases and the pericardium in 1 case. The diagnosis was made at the time from 1 day to 22 days after the surgery with an average of 8 days.Results:43 patients were cured(87.75%), 41 cases(83.67%) were cured with diet and support therapy, the course lasted from 4 days to 65 days with an average of 11 days; 1 cases, because of the poor effect of diet and support therapy, was given pleural injection of high-sugar combined with octreotide treatment; 1 case received thoracic duct ligation as the conservative therapy was ineffective; 6 cases of death due to heart failure/ severe pulmonary hypertension after operation, and parents gave up.Conclusion:Individualization conservative therapy is the first choice for chylothorax, while timely surgery can raise the survival rate and save the hospitalization time and the cost.
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Objective:To determine the risk factors of perioperative cerebral oxygen supply and utilization and cerebral activity in newborns with congenital heart disease(CHD).Methods:In this prospective cohort study, NIRS and amplitude integrated EEG(aEEG) performed before and after surgery were used to assess cerebral oxygen supply and utilization and cerebral activity in these newborns. Cerebral tissue oxygenation index(TOI) and fractional tissue oxygen extraction(FTOE) measured from NIRS for each patient were compared to background pattern and SWC of aEEG before and after surgery. Analysis included clinical characteristics and explore the risk factors of TOI, FTOE.Results:90 CHD newborns were obtained. Pre- and postoperative TOI were 0.56±0.05 and 0.59±0.03, both of them were lower than the average for normal newborns( P<0.05). Pre- and postoperative FTOE were 0.36±0.07 and 0.39±0.04. TOI and FTOE were significantly improved after surgery( P<0.05). There was negative correlation between the TOI improvement after surgery and SpO 2 of right upper limb( β: -0.202). Patient with Respiratory support before surgery had lower preoperative TOI levels( β: -0.879). Preoperative SpO 2 was higher, then preoperative TOI was also higher( β: 0.214). The postoperative FTOE of who had lower amplitude showed by aEEG was significantly lower( P<0.05). The postoperative TOI of who had immature SWC was lower than mature SWC( P<0.05). Delayed chest closure was a risk factor for postoperative death. Conclusion:TOI in children with CHD improved significantly after operative, especially in patient with cyanosis CHD. Preoperative TOI is positively related to SpO 2. It’s positive correlation between cerebral activity and cerebral oxygen utilization. The patient who has immature SWC showed lower cerebral oxygen supply. Monitoring cerebral activity and oxygenation may be useful in perioperative management and cerebral protection of newborns with CHD.
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Objective:To investigate changes in skin microecological structures and functions between acute and remission phases in adult patients with severe atopic dermatitis (AD) .Methods:From October 2019 to November 2020, skin scale specimens were collected from 5 body sites (cheeks, cubital fossa, back of the hand, abdomen, lower limbs) of 4 adult patients with severe AD in the acute and remission phases, who visited the outpatient clinic of Guangzhou Institute of Dermatology. The next-generation high-throughput sequencing was performed for metagenomic sequencing to construct the microbial gene catalogue of these specimens, followed by gene annotation and bioinformatics analysis for each sample.Results:A total of 18 phyla, 37 classes, 73 orders, 142 families, 237 genera, and 331 species were identified in the skin specimens from the 4 patients with severe AD. The patients with AD in the remission phase showed significantly increased diversity of skin microbiota and markedly different relative abundance of skin microorganisms compared with those in the acute phase (both P < 0.05). At the microbial species level, Staphylococcus aureus showed the highest impact on the acute phase of AD, while Staphylococcus epidermidis, Moraxella osloensis, Francisella sp., Staphylococcus cohnii, Staphylococcus warneri, Malassezia globosa and Malassezia restricta were enriched in the remission phase of AD with the absolute value of the common logarithm of the linear discriminant analysis score > 2 (Kruksal-Wallis test, all P < 0.05). As KEGG pathway enrichment analysis showed, the differentially abundant genes were annotated into a total of 355 functional pathways, of which 38 pathways were significantly enriched (all P < 0.05), mainly involving Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism, nitrogen metabolism, metabolism of arginine and proline, biosynthesis and degradation of valine, leucine and isoleucine, fatty acid degradation, peroxisome proliferator-activated receptor signaling pathway, etc. Conclusion:The skin microecological structure significantly differed between the acute and remission phases among the patients with severe AD, which may be related to multiple functional pathways, such as Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism and nitrogen metabolism.
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Objective:To evaluate the efficacy for nanoscale microneedle injection of compound betamethasone combined with 308 nm excimer laser in the treatment of stable vitiligo patients.Methods:A total of 80 patients with stable vitiligo were enrolled in Guangzhou Dermatology Hospital from May 2018 to May 2020. There were 40 patients (21 males and 19 females) in control group, aged 17-65 (32.4±1.7) years, and 40 patients (20 males and 20 females) in observation group, aged 18-67 (28.7±1.8) years. The control group was treated with compound betamethasone injection packet combined with 308 nm excimer laser. The observation group was treated with nanoneedle injection of compound betamethasone combined with 308 nm excimer laser. We compared the clinical efficacy and incidence of adverse reactions between the two groups.Results:Comparison of clinical efficacy showed that after 3 months of treatment, the total effective rates of the observation group and the control group were 80.00% and 67.50%, respectively, with significant difference (χ 2=4.560, P<0.05). After 3 months of treatment, the white spot area of the control group was (9.89±1.65) cm 2, which was significantly higher than that of the observation group (7.83±1.78) cm 2 ( t=5.370, P<0.05). Conclusions:The nanoneedle injection of compound betamethasone combined with 308 nm excimer laser in the treatment of stable vitiligo is effective and safe.
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Objective: To identify the factors influencing brain injury in infants with congenital heartdisease (CHD) after cardiac surgery. Methods: This retrospective study investigated 103infants with CHD undergoing cardiac surgery between January 2013 and February 2016.Pre- and postoperative amplitude-integrated electroencephalography (aEEG) recordingswere assessed for background pattern, sleep-wake cycle pattern and seizure activity.Logistic regression model was used to determine the influencing factors of brain injury.Results: Pre-operatively, most infants in our study exhibited a normal background pattern,with 16.5% showing discontinuous normal voltage, whereas this pattern was observed inonly 7.8% of infants postoperatively. The improvement in background pattern after surgerywas significant (P<0.05) in infants at no more than 39 weeks of gestational age. Infants withpostoperative sepsis or severe postoperative infection were prone to show a worse sleep-wake cycle pattern after heart surgery. Conclusion: The improvement in brain function ofinfants with CHD after cardiac surgery was associated with the gestational age andpostoperative infection
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Objective:To investigate the distribution characteristics of atherosclerosis in patients with obstructive sleep apnea syndromes (OSAS) by ultrasonography and explore the differences of intracranial and extracranial atherosclerosis lesions.Methods:From July 2016 to July 2019, 139 patients with OSAS confirmed by the department of neurology and/or respiratory of Xuanwu Hospital, Capital Medical University were enrolled retrospectively. According to the results of polysomnography (PSG), patients were divided into 3 groups: mild degree (53 cases), moderate degree (35 cases) and severe degree (51 cases). Demographic parameters, distribution and the severity of atherosclerosis both in intracranial and extracranial arteries, and the incidence of ischemic stroke were compared among the three groups.Results:①Among 139 OSAS patients, there were more males (64.7%) than females (35.3%). Of all the risk factors for cerebrovascular diseases, the prevalence of hypertensin was the highest (50.4%), followed by hyperlipidemia (48.9%). The prevalences of hypertension and ischemic stroke, the body mass index (BMI) in severe OSAS group were higher than those in mild group (all P<0.017). ②The total detection rate of extracranial atherosclerosis (83.5%) was significantly higher than that of intracranial atherosclerosis (23.0%)( P<0.01). ③The extracranial atherosclerotic lesion with highest detection rate of was simple plaque formation (51.1%, 71/139 cases), and there was no significant difference in extracranial lesions among the three groups ( P=0.106). However, with the aggravation of OSAS degree, the stenosis degree of extracranial artery increased ( P=0.006), and there was a weak correlation between the severity of OSAS and the degree of extracranial artery stenosis ( r s=0.263, P=0.002). ④The incidence of middle cerebral artery stenosis accounted for 15.8%(22/139 cases) of intracranial arteries involved and there were no significant differences in the rate, degree and distribution of intracranial artery lesions among the three groups (all P>0.05). Conclusions:The detection rate of extracranial arterial lesions in OSAS patients is higher. With the aggravation of OSAS, the degree of atherosclerosis stenosis in extracranial arteries and the incidence of ischemic stroke trend to increase.
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Objective:To investigate the safety of inter-hospital referral and the prognosis of neonatal with critical congenital heart disease.Methods:The criticality score, transit distance and time, and the prognosis of 237 newborns with critical congenital heart disease in Guangdong Provincial People′s Hospital from July 2016 to July 2018 were retrospectively analyzed.Results:A total of 237 children were included (162 male and 75 female) with the median age of 6 days and the median body weight of 2.98 kg.The median transit distance was 90 km.The average value of neonatal critical illness score (NCIS) was (86.54±9.05) scores before transport; 136 cases were greater than 90 scores, 84 cases between 70 and 90 scores, 17 cases less than 70 scores; while the average NCIS was (87.05±8.19) scores when arrived at neonatal intensive care unit (NICU), 138 cases were greater than 90 scores, 82 cases between 70 and 90 scores, 17 cases less than 70 scores.There were no significant differences in the scores of critical cases before and after transfer according to the transfer time and distance ( t=0.346, P>0.05). There was no one death occurred during the transfer process.All over, 222 cases were cured and discharged from the hospital after surgery and or medical interventional treatments, 15 cases died after giving up treatment or losing the opportunity for surgery. Conclusions:It is safe and effective of the inter-hospital transport for the rescue of infants with critical congenital heart disease when followed the principles and transport rules and regulations, with trained workers and special equipments.
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Objective:To explore the differential expression of Toll-like receptor 7/9 and myeloid differentiation factor 88 (MyD88) in skin lesions between patients with vitiligo and healthy individuals as well as their clinical significance.Methods:We collected vitiligo patients in the Guangzhou Institute of Dermatology and Venerology from June 2016 to June 2018. There were 24 vitiligo patients, 12 males and 12 females, aged 5 to 65 (28.75±13.12) years, with medical history of 14 days to 20 years. The expression levels of TLR7/9 and MyD88 in skin lesions were determined from 24 patients with vitiligo and 20 healthy controls by immunohistochemistry.Results:The expression levels of TLR7 and MyD88 in skin lesions were significantly higher in patients with vitiligo than that in the controls, and the difference was statistically significant. The expression level of TLR9 in skin lesions was significantly higher in patients with vitiligo than that in the controls, while no significant difference was observed between the two groups.Conclusions:The expression level of TLR7 and TLR9 is elevated in skin lesions from patients with vitiligo. The abnormal expression level of TLR7 and TLR9 possibly participates in the pathogenesis of vitiligo.
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Metagenomic analyses of humans and animals have showed that atopic dermatitis (AD) is associated with microbiome dysbiosis in the gut and skin. Decrease of microbial diversity can cause damage to skin barrier and aggravation of AD, and gut microbiome may be involved in the occurrence and development of AD through immune, metabolic and neuroendocrine pathways. This review summarizes the latest advances in the application of metagenomics in tmicrobiological research in and treatment of AD, possible mechanisms underlying microbiome-mediated pathogenesis of AD, and provides a theoretical reference for the microecological therapy of AD.
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Objective@#To analyze the neurodevelopmental outcome and its risk factors in infants with CHD at 18 months of age.@*Methods@#Eighteen-month-old infants with CHD at the follow-up clinic of our hospital were selected. The Bayley scales of infant development(BSID) were used to evaluate the levels of mental development(MDI) and psychomotor development(PDI). The clinical features during hospitalization were reviewed, and the risk factors of MDI and PDI were analyzed.@*Results@#A total of 116 children with CHD underwent BSID evaluation at 18 months of age. Both the MDI(95.38±22.98) and PDI(87.84±22.57) of the cohort were significantly lower than the average value of the normal population(P<0.05). In infants with cyanotic CHD, the MDI was higher(β=17.218). The longer the length was of the hospital stay, the lower the PDI(β=-0.577). In patients undergoing cardiopulmonary bypass surgery, the PDI was higher(β=11.956). Compared to infants with relatively normal behavior, the PDI of infants with mild behavioral problems was lower(β=-10.605).@*Conclusion@#Children with CHD who underwent cardiac surgery have delayed neurodevelopmental outcomes compared with those of healthy children. The outcomes of infants with cyanotic CHD or undergoing cardiopulmonary bypass surgery was better than others. Long hospital stays and mild behavioral problems were risk factors for poor neurodevelopmental outcomes.
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Objective@#To identify differentially expressed genes in the transcriptome of the lesional versus nonlesional skin tissues of patients with moderate and severe atopic dermatitis (AD) , and to elucidate their roles in the pathogenesis of AD.@*Methods@#From July to October in 2016, lesional and nonlesional skin tissues were obtained from 5 outpatients of Han nationality with AD in Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University. The next-generation high-throughput transcriptome-wide RNA sequencing (RNA-seq) was performed to identify differentially expressed genes, which were subjected to GO function annotation and KEGG pathway analysis. Real-time fluorescence-based quantitative PCR (qRT-PCR) was conducted to verify differences in candidate gene expression between lesional and nonlesional skin tissues.@*Results@#An average of 10.96 GBs sequence reads were acquired among 10 samples. A total of 21 729 genes were detected, including 19 268 known genes and 2 545 predicted novel genes. A total of 23 153 new transcripts were detected, of which 18 889 were new alternative splicing subtypes of known protein-coding genes, 2 545 were transcripts belonging to new protein-coding genes, and the remaining 1 719 belonged to long-stranded non-coding RNA. Totally, 78 differentially expressed genes were identified between the lesional and nonlesional skin tissues, including 69 upregulated and 11 downregulated genes in the lesional skin tissues. Among them, there were several genes known to be associated with AD inflammation (CXCL1/2/8, IL6/IL1β, MMP1, SERPINB4, S100A2, GZMB, OASL, OSM) and barrier (KRT16, FABP5, CYP1A1) and keratinocyte differentiation (IL-20) . GO analysis revealed that functions of 72 differentially expressed genes could be annotated. KEGG pathway analysis showed that the differentially expressed genes were grouped into 132 signaling pathways, of which 13 were significantly enriched, including the interleukin (IL) -17 pathway, NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, etc. qRT-PCR showed that the mRNA expression levels of candidate genes CXCL1, KRT6A, IL36A, SERPINB4 and PSAPL1 was consistent with the transcriptome sequencing results.@*Conclusions@#Differentially expressed genes and related important regulatory signaling pathways were identified between the lesional and nonlesional skin tissues of patients with AD at the transcriptional level, and the IL-17 pathway was found to be mostly enriched in AD lesions in patients of Han nationality. These findings provide an important basis for further study on the pathogenesis of AD..
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Objective To analyze the neurodevelopmental outcome and its risk factors in infants with CHD at 18 months of age. Methods Eighteen-month-old infants with CHD at the follow-up clinic of our hospital were selected. The Bayley scales of infant development( BSID) were used to evaluate the levels of mental development( MDI) and psychomotor develop-ment( PDI) . The clinical features during hospitalization were reviewed, and the risk factors of MDI and PDI were analyzed. Results A total of 116 children with CHD underwent BSID evaluation at 18 months of age. Both the MDI(95. 38 ± 22. 98) and PDI(87.84 ±22.57) of the cohort were significantly lower than the average value of the normal population(P<0.05). In infants with cyanotic CHD, the MDI was higher(β=17. 218). The longer the length was of the hospital stay, the lower the PDI (β= -0. 577). In patients undergoing cardiopulmonary bypass surgery, the PDI was higher(β=11. 956). Compared to in-fants with relatively normal behavior, the PDI of infants with mild behavioral problems was lower(β=-10. 605). Conclusion Children with CHD who underwent cardiac surgery have delayed neurodevelopmental outcomes compared with those of healthy children. The outcomes of infants with cyanotic CHD or undergoing cardiopulmonary bypass surgery was better than others. Long hospital stays and mild behavioral problems were risk factors for poor neurodevelopmental outcomes.
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Objective To identify differentially expressed genes in the transcriptome of the lesional versus nonlesional skin tissues of patients with moderate and severe atopic dermatitis(AD), and to elucidate their roles in the pathogenesis of AD. Methods From July to October in 2016, lesional and nonlesional skin tissues were obtained from 5 outpatients of Han nationality with AD in Guangzhou Institute of Dermatology, Institute of Dermatology, Guangzhou Medical University. The next-generation high-throughput transcriptome-wide RNA sequencing (RNA-seq) was performed to identify differentially expressed genes, which were subjected to GO function annotation and KEGG pathway analysis. Real-time fluorescence-based quantitative PCR(qRT-PCR)was conducted to verify differences in candidate gene expression between lesional and nonlesional skin tissues. Results An average of 10.96 GBs sequence reads were acquired among 10 samples. A total of 21729 genes were detected, including 19268 known genes and 2545 predicted novel genes. A total of 23153 new transcripts were detected, of which 18889 were new alternative splicing subtypes of known protein-coding genes, 2545 were transcripts belonging to new protein-coding genes, and the remaining 1719 belonged to long-stranded non-coding RNA. Totally, 78 differentially expressed genes were identified between the lesional and nonlesional skin tissues, including 69 upregulated and 11 downregulated genes in the lesional skin tissues. Among them, there were several genes known to be associated with AD inflammation (CXCL1/2/8, IL6/IL1β, MMP1, SERPINB4, S100A2, GZMB, OASL, OSM) and barrier (KRT16, FABP5, CYP1A1) and keratinocyte differentiation (IL-20). GO analysis revealed that functions of 72 differentially expressed genes could be annotated. KEGG pathway analysis showed that the differentially expressed genes were grouped into 132 signaling pathways, of which 13 were significantly enriched, including the interleukin(IL)-17 pathway, NOD-like receptor signaling pathway, Toll-like receptor signaling pathway, etc. qRT-PCR showed that the mRNA expression levels of candidate genes CXCL1, KRT6A, IL36A, SERPINB4 and PSAPL1 was consistent with the transcriptome sequencing results. Conclusions Differentially expressed genes and related important regulatory signaling pathways were identified between the lesional and nonlesional skin tissues of patients with AD at the transcriptional level, and the IL-17 pathway was found to be mostly enriched in AD lesions in patients of Han nationality. These findings provide an important basis for further study on the pathogenesis of AD. .
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Objective: To develop a reliable model of pancreatic carcinogenesis and liver metastasis in mice and preliminarily analyze metastasis-related molecules. Methods: Liver metastasis models of pancreatic cancer were made by injecting murine Panc-2 cells in the spleens of 12 C57/BL6 mice. Six mice in the control group were injected with phosphate buffered saline. Liver metastases were de-tected pathologically in the experimental group. Quantitative real-time PCR was used to analyze the variation in the expression levels of metastasis-related molecules in the tumor tissue located in the spleen, metastatic tumor tissues in the liver, and liver tissue adja-cent to metastatic carcinoma. Results: In the experimental group, the incidence rate of liver metastasis was 83.33%. An anatomical study showed that there was a single giant tumor nodule at every injection site in the spleen, while multiple nodular metastases ap-peared in the livers of 10 mice, with the liver tumorigenesis rate 83.33%. The pathological results indicated that the tumor cell pattern of liver metastasis was in accordance with pancreatic adenocarcinoma. CCL-17, CCL-22, CD44, and other molecules had higher impres-sion levels in the metastatic tumor tissues in the liver and the tumor tissue of spleen than in the liver tissue adjacent to metastatic car-cinoma. Expression levels of Ang-2, BAK, BAx, and other molecules were higher in the liver tissue adjacent to metastatic carcinoma, and the relative expression level of gene was more than 1 (P<0.05). Conclusions: Intrasplenic injection of pancreatic cancer cells suc-cessfully developed a model of liver metastasis that partly mimicked the natural metastatic process, which showed variations in the ex-pression levels of metastasis-related molecules similar to that in the human body. This is a reliable method to produce pancreatic can-cer liver metastasis in mice and may be valuable in experimental studies for screening anti-tumor durgs.
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Objective To evaluate the clinical efficacy of Yangxue-Pinggan decoction on intractable headache. Methods A total of 66 patients with intractable headache who met the inclusion criteria were randomly divided into two groups by random number table method, 33 in each group. The control group was given flunarizine hydrochloride capsule orally, while the treatment group was given professor Guan Youbo's Yangxue-Pinggan decoction. Both groups were treated for 4 weeks. The improvement rates of headache were observed. The headache attacks, the degree of headache, the duration of headache and the accompanying symptoms were scored, and the clinical efficacy was evaluated. Results The total effective rate was 97.0％ (32/33) in the treatment group and 63.6％ (21/33) in the control group, which there was significant difference between the two groups (χ2=11.591, P=0.001). After treatment, the scores of the headache attacks, the degree of headache, the duration of headache and the accompanying symptoms in the treatment group were significantly lower than those in the control group (t=17.689, 12.523, 26.907, 25.569, P<0.001). Conclusions The Yangxue-Pinggan decoction can obviously improve the clinical symptoms of intractable headache, relieve the pain degree and reduce the number of attacks, and its clinical efficacy is better than oral flunarizine hydrochloride capsule.
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Objective To evaluate the effect of curcumin on phagocytic function of macrophages after the stimulation with exosomes from patients with systemic lupus erythematosus (SLE).Methods From February 2016 to November 2017,18 patients with active SLE and 18 healthy controls were enrolled from Guangzhou Institute of Dermatology and Sun Yat-sen Memorial Hospital,Sun Yat-sen University,and serum exosomes were extracted from these subjects.The exosomes from the healthy controls (CON-exo) and SLE patients (SLE-exo) as well as different concentrations (1,5,20 μmol/L) of curcumin were used alone or in combination to stimulate the acute monocytic leukemia cell line THP-1-derived macrophages.After coincubation of the stimulated macrophages with pHrodo TM Red indicator,flow cytometry was performed to determine the average fluorescence intensity,immunofluorescence staining to calculate the proportion of pHrodo TM Red-positive macrophages,and then the phagocytic activity of macrophages was assessed.Western blot analysis was conducted to determine the protein expression of CD 14 in the stimulated macrophages.Statistical analysis was carried out by Student-t test for comparison between two groups,oneway analysis of variance for comparison among several groups,and least significant difference (LSD)-t test for multiple comparisons.Results Flow cytometry showed that there were significant differences in the relative fluorescence intensity of macrophages among the CON-exo group,CON-exo + 20 μmol/L curcumin group,SLE-exo group and SLE-exo + 20 μmol/L curcumin group (101.3％ ± 14.05％,94.27％ ± 14.13％,41.02％ ± 9.54％ and 87.33％ ± 15.01％,respectively;F =10.81,P ＜ 0.01),and immunofluorescence staining revealed that the proportion of pHrodo Red-positive macrophages significantly differed among the above 4 groups (82.16％ ± 5.20％,81.33％ ± 4.51％,54.20％ ± 9.31％ and 71.23％ ± 5.43％ respectively;F =12.42,P ＜ 0.01).The fluorescence intensity of macrophages and proportion of pHrodo-positive macrophages were both significantly lower in the SLE-exo group than in the CON-exo group (t =5.26,5.35 respectively,both P ＜ 0.01) and SLE-exo + 20 μmol/L curcumin group (t =3.97,3.26 respectively,both P ＜ 0.05).Western blot analysis showed that there were significant differences in the protein expression ofCD14 among the CON-exo group,SLE-exo group,SLE-exo + 1 μmol/L curcumin group,SLE-exo + 5 μmol/L curcumin group and SLE-exo + 20 μmol/L curcumin group (96.33％ ± 13.65％,30.67％ ± 5.86％,45.24％ ± 8.89％,72.81％ ± 6.62％ and 90.67％ ± 12.66％ respectively;F =24.57,P ＜ 0.01).The protein expression of CD14 was significantly lower in the SLE-exo group than in the CON-exo group(t =8.06,P ＜ 0.001),SLEexo + 5 μmol/L curcumin group and SLE-exo + 20 μmol/L curcumin group(t =5.08,7.38,both P ＜ 0.001),and the CD14 level showed an increasing trend along with the increase in the concentration of curcumin.Conclusion Exosomes from SLE patients markedly inhibit the phagocytosis of macrophages,while curcumin can reverse this inhibitory effect.