Effects of calcium-sensitive receptors on 11β-hydroxysteroid dehydrogenase type 2 and cortisol in neonatal mice with persistent pulmonary hypertension / 中国当代儿科杂志

OBJECTIVE@#To investigate the effects of calcium-sensitive receptors (CaSR) on the expression of 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) and cortisol concentration in a neonatal mouse model of persistent pulmonary hypertension (PPH).@*METHODS@#Fifty-six newborn C57BL/6 mice were randomly divided into a control group (n=14), a PPH group (n=14), an agonist group (n=14), and an inhibitor group (n=14). The mice in the PPH, agonist, and inhibitor groups were exposed to a 12% oxygen concentration, and the agonist group and inhibitor group were given CaSR agonist (GdCl3, 16 mg/kg) and CaSR antagonist (NPS2390, 1 mg/kg) intraperitoneally once a day, respectively. The mice in control group were exposed to air, and then injected with an equal volume of normal saline as those in the PPH group every day. All mice were treated for 14 days. Morphological examination of heart and lung tissues was performed using hematoxylin-eosin staining. The expression levels of 11β-HSD2 mRNA and 11β-HSD2 protein in lung tissues were measured by qRT-PCR and Western blot respectively. Brain natriuretic peptide (BNP) and cortisol levels in lung tissues were determined using ELISA.@*RESULTS@#Compared with the control group, the PPH group had significantly increased pulmonary artery wall thickness (WT%), ratio of right to left ventricular thickness (RV/LV), alveolar mean linear intercept, and BNP concentration and a significantly reduced radial alveolar count (P<0.05); compared with the PPH group, the agonist group showed significant increases in WT% and BNP concentration, while the inhibitor group showed significant reductions in the two indicators (P<0.05). Compared with the control group, the PPH group showed significant reductions in the expression levels of 11β-HSD2 mRNA and 11β-HSD2 protein, but a significant increase in cortisol concentration (P<0.05); compared with the PPH group, the agonist group had significantly lower expression levels of 11β-HSD2 mRNA and 11β-HSD2 protein, but a significant higher cortisol concentration, while the inhibitor group showed opposite changes in these indicators (P<0.05).@*CONCLUSIONS@#CaSR may control the development and progression of PPH in newborn mice by regulating the expression of 11β-HSD2 and cortisol concentration.

Prospective clinical study of radix astragali and its compound prescription for treatment of β-thalassemia in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of radix astragali and its compound prescription for treatment of β-thalassemia in children.</p><p><b>METHODS</b>This study was a randomized, controlled, double-blind clinical trial. Fifty-seven children with β-thalassemia were randomly assigned to radix astragali, compound prescription (radix astragali+ codonopsis pilosula + tortoise plastron) and placebo control groups after stratifying the patients according to disease type (intermedia and major). The parameters of hematology and safety were assessed after 12 weeks of treatment.</p><p><b>RESULTS</b>After 12 weeks of treatment, the mean Hb elevation levels in children with β-thalassemia intermedia from the compound prescription and the radix astragali groups were 1.21±1.12 and 1.05±0.80 g/dL respectively compared with -(0.28±0.51) g/dL in the placebo control group (P<0.01). Mean Hb levels in the compound prescription and radix astragali groups were significantly higher than in the placebo control group (P<0.05). Therapy with both radix astragali and its compound prescription increased fetal hemoglobin, red blood cell, mean corpuscular hemoglobin and reticulocyte levels in children with β-thalassemia intermedia. The total effective rates were 64% and 62% in children with β-thalassemia intermedia from the compound prescription and radix astragali groups respectively, which was significantly higher than in the placebo control group (9%; P<0.01). Therapy with radix astragali or its compound prescription in children with β-thalassemia major had similar but less favourable effects than the same therapy in children with β-thalassemia intermedia. White blood cell, neutrophil, platelet and hepatic and renal functions were not adversely affected by the medicines.</p><p><b>CONCLUSIONS</b>Therapy with radix astragali or its compound prescription is effective and safe in children with β-thalassemia.</p>

Ulnar osteotomy and internal fixation for old anterior dislocation of radial head in children / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical results of ulnar osteotomy and internal fixation in treating old anterior dislocation of radial head in children.</p><p><b>METHODS</b>From Jan.2004 to Jan.2010, 18 patients with old anterior dislocation of radial head were treated with open reduction for radial head and ulnar osteotomy and internal fixation, including 12 males and 6 females with an average age of (6.9 +/- 1.3) years (3 to 15 years). Among them, 15 cases had history of external injury, from injury to operation was for 5-65 months with an average of (24.0 +/- 5.5) months. Limitation of activity occurred in all patients including flexion and extension of elbow joint and rotation of forearm, without radial nerve injury and obviously radial head deformation.</p><p><b>RESULTS</b>All incisions obtained primary healing and no nonunion, re-dislocation of radial head and nerve injury were found. All patients were followed up from 9 to 38 months with an average of (17.0 +/- 4.5) months. Union time of fracture was from 2.3 to 3.9 months with an average of (2.8 +/- 0.5) months. Postoperative activity in flexion and extension of elbow joint and rotation of forearm improved significantly compared with preoperative. The clinical effects were evaluated according to Zhuyukui criteria, 14 patients got excellent results, 3 good, 1 fair.</p><p><b>CONCLUSION</b>Ulnar osteotomy and internal fixation in treating old anterior dislocation of radial head in children can obtain satisfactory results and effectively improve the activities in flexion and extension of elbow joint and rotation of forearm and prevent re-dislocation of radial head.</p>

Resection of a giant renal angiomyolipoma in a solitary kidney with preoperative arterial embolization / 中华医学杂志(英文版)

Renal angiomyolipoma is a type of benign tumor that occurs sporadically in addition to being associated with tuberous sclerosis. Preoperative embolization of large tumors is important to avoid excessive blood loss during surgery. We reported a patient with a 5505-g giant renal angiomyolipoma in a solitary kidney. The patient was treated with preoperative embolization and radical nephrectomy without complications. This type of treatment for an enormous angiomyolipoma can reduce the risk of uncontrolled hemorrhage caused by rupture of the tumor during the operation and should be considered for the treatment of similar tumors.

Correlation between activation of L5-S2 spinal cord astrocytes and effect of substance P in chronic prostatitis pain / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the expressions of the substance P (SP) mRNA and neurokinin-1 receptor (NK-1R) in the posterior horn of the L5 - S2 spinal cord in the rat model of chronic prostatitis pain, and to investigate the changes in the activation of astrocytes and influence of SP on this activation in rat spinal cord astrocytes cultured in vitro.</p><p><b>METHODS</b>The rat model of chronic prostatitis pain was established by injection of complete Freund's adjuvant (CFA) and assessed by the tail flick threshold test, the control rats injected with sodium chloride and all observed at 0, 14 and 28 days. Changes in the expressions of SP mRNA, NK-1R, glial fibrillary acidic protein (GFAP), tumor necrosis factor-alpha (TNF-alpha) and inducible nitric oxide synthase (iNOS) in the posterior horn of the L5 - S2 spinal cord were detected by RT-PCR and Western blot. Rat spinal cord astrocytes were cultured in vitro and divided into a control group, cultured with ITS cell culture fluid, and two experiment groups, with Group 1 stimulated with SP at the concentration of 10(-9) - 10(-6) mol/L for 12 hours followed by determination of the expressions of TNF-alpha, IL-1beta, NO and NOS by ELISA and nitrate reductase and colorimetric methods, and Group 2 at 10(-7) mol/L for 0, 24, 48 and 72 hours followed by detection of the GFAP expression by Western blot.</p><p><b>RESULTS</b>The expressions of SP mRNA, NK-1 R, GFAP, TNF-alpha and iNOS in the posterior horn of the L5 - S2 spinal cord were obviously higher in the rat prostatitis pain models than in the controls, successively higher at 28 than at 14 and 0 d (P < 0.01), and so was the expression of GFAP at 28 than at 14 d in the experiment groups (P < 0.05). SP induced a gradual increase at 10(-7) mol/L in the expression of GFAP in the spinal cord astrocytes at 0 -72 h, significantly different from that of the control group (P < 0.01), and it promoted the excretion of TNF-alpha and IL-1beta and the activity of NO and NOS at 10(-9) - 10(-6) mol/L at 12 h in a concentration-dependent manner, with marked differences between the experiment and control groups (P < 0.01, P < 0.05). But a decreased excretion of IL-1 beta was observed in the 10(-6) mol/L group, though with no significant difference from the control (P > 0.05).</p><p><b>CONCLUSION</b>Chronic prostatitis pain could upregulate the expressions of the excitatory transmitter SP and receptor in the L5 - S2 spinal cord, and result in the activation of astrocytes and increased excretion of proinflammatory cytokines, which may be associated with the persistence and generalization of prostatitis pain.</p>

Treatment of infected bone defect with one stage open cancellous bone grafting / 中国骨伤

<p><b>OBJECTIVE</b>To explore the feasibility of the treatment of infected bone defect with one stage open cancellous bone grafting and summarize the key factors improving the curative effects.</p><p><b>METHODS</b>Twelve cases of infected bone defects were reviewed, which involved 8 male and 4 female with an average age of 42 years (range, 22 to 68 years). The study consisted of 7 cases of calcaneal defects, 4 tibial defects and 1 femoral defect. The procedure included dressing change, resection of the devitalized soft tissue and bone tissue. After the debridement, the bone defect at one stage was treated with cancellous bone grafting and the wound was open. The wound was closed with skin transplantation when it was covered by granulation tissue completely.</p><p><b>RESULTS</b>The wound was covered with granulation tissue in the average 24.1 days after operation and was closed in the average 30.3 days. All the patients were followed up for 8 to 30 months with an average time of 18 months. All the bone defects were healing after bone grafting and there was no infection recurrence.</p><p><b>CONCLUSION</b>One stage open cancellous bone graft is an easy and feasible treatment for infected bone defect. Resecting of the devitalized tissue before operation, radical debridement, enough bone graft in operation and careful dressing change after operation are all the key factors to acquire the satisfactory outcome.</p>