A biomechanical study on proximal junctional kyphosis following long-segment posterior spinal fusion

Posterior long-segment spinal fusion may lead to proximal junctional kyphosis (PJK). The present study sought to identify the appropriate fusion levels required in order to prevent PJK using finite element analysis. A finite element model was constructed based on the whole-spine computed tomography findings of a healthy adult. Nine commonly used posterior spinal fusion methods were selected. Stress on the annulus fibrosis fibers, the posterior ligamentous complex, and the vertebrae after various spinal fusions in the upright position were compared. This study was divided into two groups: non-fusion and fusion. In the former, the stress between the T10 and the upper thoracic vertebrae was higher. Comparing thoracic and lumbar segments in the fusion group, the peak stress values of the upper instrumented vertebrae (UIV) were mainly observed in T2 and L2 whilst those of the UIV+1 were observed in T10 and L2. After normalization, the peak stress values of the UIV and UIV+1 were located in T2 and L2. Similarly, the peak stress values of the annulus fibrosus at the upper adjacent level were on T10 and L2 after normalization. However, the peak stress values of the interspinal/supraspinal complex forces were concentrated on T11, T12, and L1 after normalization whilst the peak stress value of the pedicle screw was on T2. Controversy remains over the fusion of T10, and this study simulated testing conditions with gravitational loading only. However, further assessment is needed prior to reaching definitive conclusions.

Effect of Homeobox A13 transfection on epithelial-mesenchymal transition and bone morphogenetic protein-7 expression in kidney tubular epithelial cells / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine the transfection of Homeobox A13 (HOXA13) on epithelial-mesenchymal transition (EMT) and the expression of bone morphogenetic protein-7 (BMP-7) induced by albumin-overload in human kidney tubular epithelial cells (HKCs).</p><p><b>METHODS</b>The cultured HKCs were treated with 20 mg/mL human serum albumin (HSA) for 48 hours. Protein expression of cytokeratin (CK), vimentin and HOXA13 in the HKCs was assessed by Western blot. Protein expression of CK, vimentin, and BMP-7 was also detected in HKCs transfected with lipofectamine contained HOXA13 DNA.</p><p><b>RESULTS</b>HSA induced EMT in HKCs, presented by decreased CK expression (P<0.01) and increased vimentin expression (P<0.01). The up-regulated expression of HOXA13 transfected by lipofectamine inhibited the level of EMT induced by HSA in HKCs (P<0.05). The decreased rate of BMP-7 protein expression induced by HSA was inhibited by over-expressed HOXA13 in HKCs (P<0.05).</p><p><b>CONCLUSIONS</b>Transfection of HOXA13 in HKCs could inhibit the degree of EMT induced by albumin-overload, possibly by increasing BMP-7 expression.</p>

Hazardous environmental factors causing renal damage in children / 中国当代儿科杂志

Hazardous environmental factors invade the body through multiple routes, including ingestion, inhalation and absorption by contact with the skin and mucous membrane. They are from various sources and soil, water, air, building and decorative materials, foods and daily necessities are the main carriers. According to their physical and chemical properties and morphological characteristics, these hazardous factors are classified as metals, inorganic matter, organic matter, radioactive substances, biological toxins, viruses, bacteria, mycoplasmas, chlamydiae and parasites. They cause diseases through blood and urine and also have kidney susceptibility. This article suggests that pediatricians should fully understand the characteristics and seriousness of hazardous environmental factors that cause renal damage, and pay attention to the prevention and control of these factors so as to minimize renal damage in children.

Environment and congenital urinary malformations / 中国当代儿科杂志

The development of the kidneys and other organs of the urinary tract follows the natural rule of gene-environment-lifestyle interaction. Both intrinsic and extrinsic factors may be associated with the etiology of various kinds of urinary malformations, but the environmental factor is an extrinsic factor. Related literatures were reviewed in this paper, which focuses on the association of congenital urinary malformations with possible environmental factors. It is concluded that urinary malformation is associated with low birth weight, maternal disease, placental insufficiency, maternal drug exposure, and maternal exposure to environmental pesticides. Living environment and socioeconomic factors may also influence the incidence of urinary malformation.

Effect and possible mechanism of hemoperfusion treatment for severe Henoch-Sch(o)nlein purpura / 中华实用儿科临床杂志

Objective To research the changes of clinical symptoms and serum free radical in children with severe Henoch-Sch(o)nlein purpura (HSP) between before and after accepted hemoperfusion.And evaluate the curative effect of hemoperfusion treatment for severe HSP and discuss the mechanism.Methods Twenty-three severe HSP patients in Children's Medical Center of the Second Xiangya Hospital of Central South University which were divided into 2 groups:13 cases were divided into traditional treatment group,10 cases were divided into hemoperfusion group; 11 healthy children were divided into healthy control group.The alleviate situation of clinical symptoms were observed and recorded such as purpura,abdominal pain,joint pain,hematuria,albuminuria,and the changes of urine RBC count,24 hour urine protein quantitative before and after hemoperfusion and traditional treatment.Collected the serum before and after the first time hemoperfusion treatment,after the second time hemoperfusion treatment,after the third time hemoperfusion treatment in hemoperfusion group;Collected the serum before and after conventional therapy in traditional treatment group; Collected only once serum in healthy control group.And then their superoxide anion(O2-·),hydroxy radical(· OH),hydrogen dioxide(H2O2),malonaldehyde(MDA) values were detected with spectrophotometry.The differences of each index among each group were compared respectively.Results After treatment,the clinical symptoms of 23 severe HSP children such as rash,abdominal pain,joint pain,hematuria,albuminuria which were reliefed compared to before treatment.The urine erythrocyte count,24 hour urine protein quantitative were reduced in 2 groups,but the symptoms of perfusion group children relieved faster,and the clinical index decreased more obviously.The serum O2-·,· OH,H2O2,MDA levels of 23 HSP children were significantly higher than those of the healthy control group (all P ＜ 0.01).In the traditional treatment group,compared between before and after treatment,the indexes were decreased (all P ＜ 0.05) ; After 3 times of hemoperfusion,all indexes were decreased in hemoperfusion group,but only after the third hemoperfusion the indexes were decreased statistically significant(all P ＜ 0.05).But compared with the hemoperfusion group,the index were decreased more apparently in after the third hemoperfusion,and it was statistically significant (P ＜ 0.05).Conclusions 1.The serum free radicals are increased in severe HSP children,they may play a role in vasculitis.2.For severe HSP,the recent therapeutic effect of hemoperfusion ally with traditional treatment is better than the alone traditional treatment.3.Hemoperfusion ally with traditional treatment can remove more effectly the serum free radicals,reduce lipid peroxide products,then mitigate the damage of the oxidate stress to the vascular endothelial.

Clinical and pathological analysis of 41 children with lupus nephritis / 中华实用儿科临床杂志

Objective To analyze the correlation between clinical characteristics and pathological findings lupus nephritis (LN) in children,together with the correlation of the renal vascular lesion respectively with the glomerular lesion and tubulointerstitial lesion.Methods Forty-one cases of LN in children diagnosed by percutaneous renal biopsy from Jan.2008 to Sep.2012 in Pediatrics of the Second Xiangya Hospital of Central South University were collected.Clinical manifestations and the lab findings of the blood and urine of all the patients were analyzed,and all the frozen sections were evaluated according to the standard of ISN/RPS2003 for LN.The glomerular lesion and tubalointerstitial lesion separately were also evaluated,respectively.The wall thickening/outer diameter ratio,intima thickening/outer diameter ratio and medial thickening/outer diameter ratio of the arterioles were measured.Results The percentage of clinical manifestation with LN increased coupled with the degree of pathological damage.In the different stages of pathological damage,both the glomerular lesion and tubulointerstitial lesion were getting much more serious along with the progressiveness of pathological damage,and what's more,they had a positive correlation(r =0.959,P ＜ 0.05).The wall thickness/outer diameter ratio in all cases was greater than 0.5,in dicating the thickness of vessel wall.Conclusion Renal vascular lesion really existed and is characterized by the progressive loss of integrity of the intima and the medial thickening.

Expression of urinary neutrophil gelatinase-associated lipocalin and its clinical significance in children with idiopathic nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration in children with idiopathic nephrotic syndrome (INS) and its clinical significance.</p><p><b>METHODS</b>Thirty-four children newly diagnosed with INS received oral prednisone for 4 weeks. Patients whose urinary protein did not become negative were classified as steroid-resistant nephrotic syndrome (SRNS) group, while those whose urinary protein did become negative were classified as steroid-sensitive nephrotic syndrome (SSNS) group. Morning midstream urine specimens were collected from all patients before use of prednisone and after 1, 2, 3, and 4 weeks of treatment with prednisone. Enzyme-linked immunosorbent assay was used to measure the urinary NGAL concentration. Meanwhile, urinary creatinine (Cr) concentration was measured, and urinary NGAL concentration in a single urine collection was adjusted according to the urinary Cr excretion. The two groups were compared in terms of urinary NGAL/Cr ratio.</p><p><b>RESULTS</b>Compared with the SRNS group, the SSNS group had significantly decreased urinary NGAL/Cr ratios after 3 and 4 weeks of prednisone treatment (P < 0.05). Compared with the SRNS group, the SSNS group had a significantly decreased urinary β2-MG/Cr ratio after 4 weeks of prednisone treatment (P < 0.05). In both groups, urinary NGAL/Cr ratio was positively correlated with urinary protein/Cr ratio (r = 0.510, P < 0.01). The results of ROC curve analysis showed when diagnostic cut-off point of urinary NGAL/Cr was 0.043 by 3 weeks after treatment, sensitivity and specificity achieved 100% and 79.2% respectively.</p><p><b>CONCLUSIONS</b>Urinary NGAL/Cr ratio remains high in children with SRNS, while this ratio decreases gradually during prednisone treatment in children with SSNS, and it falls ahead of urinary β2-MG/Cr ratio. These results suggest that dynamic monitoring of urinary NGAL/Cr ratio is useful for early judgment of response to prednisone in patients with INS.</p>

Circulating microRNA expression in children with idiopathic short stature / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the role of circulating microRNAs (miRNA) in the pathogenesis of idiopathic short stature (ISS) through detecting miRNA expression profile in plasma of children with ISS.</p><p><b>METHODS</b>Plasma miRNA expression was determined by microarray in 20 children with ISS and 20 healthy children. Altered microRNAs were verified by real-time PCR. The online miRNA target gene prediction software was used to predict and screen miRNA differentially expressed target genes.</p><p><b>RESULTS</b>According to the microarray, there were 40 differentially expressed miRNAs in the ISS group compared with the control group, including 24 up-regulated miRNAs and 16 down-regulated miRNAs. Real-time PCR verified two up-regulated (miR-185and miR-574-5p) and two down-regulated miRNAs (miR-497and miR-15a) and confirmed that plasma miR-185 expression was significantly up-regulated (P<0.05) and miR-497 expression was significantly down-regulated (P<0.05) in children with ISS.</p><p><b>CONCLUSIONS</b>Plasma miRNA expression levels in children with ISS are significantly different from healthy controls, suggesting that plasma miRNA is associated with the pathogenesis of ISS.</p>

Application of stem cell transplantation in kidney diseases / 中国当代儿科杂志

This paper summarizes the current literature on the potential therapeutic role of stem cell transplantation for kidney injury and repair and focuses on the choice of types of stem cells, the method of transplantation, and the mechanisms of stem cell homing to injured renal tissues and its protective effects. The application of umbilical cord mesenchymal stem cells (UC-MSCs) shows wide prospects, but the approach and optimal dose of cell transplantation are under intensive investigation. Signals that regulate stem cell homing to injured renal tissues may be related to chemokines or factors released in the target site. Several studies have pointed out that paracrine and endocrine of stem cells are the most likely mechanism of action in the injured nephron. Many questions remain unanswered but stem cell-based therapy is a promising new strategy for acute and chronic kidney diseases.

Effects of huai qi huang on cytokines Th1, Th2 and Th17 and phagocytosis of alveolar macrophages in rats with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of huai qi huang, a traditional Chinese medicine, on cytokines Th1, Th2 and Th17 levels and alveolar macrophage phagocytosis in asthmatic rats sensitized by ovalbumin (OVA).</p><p><b>METHODS</b>Forty male Sprague-Dawley rats were randomly divided into five groups: normal control, untreated asthma, budesonide-treated, huai qi huang-treated and budesonide+huai qi huang-treated asthma (n=8 each). Asthma was induced by OVA sensitization and challenge. The levels of IL-4, IFN-γ and IL-17 in plasma and bronchoalveolar lavage fluid (BALF) were measured using ELISA. The phagocytosis of alveolar macrophages which were isolated and purified from BALF was evaluated by the colorimetric assay.</p><p><b>RESULTS</b>The levels of IL-4 and IL-17 increased, in contrast, the IFN-γ level decreased in plasma and BALF in the untreated asthma group compared with those in the normal control group. The IFN-γ level in the huai qi huang-treated asthma group was higher than that in the untreated asthma group. The IFN-γ level increased and the IL-17 level decreased more significantly in the budesonide+huai qi huang-treated asthma group when compared with the budesonide and huai qi huang alone treatment groups. The phagocytosis of alveolar macrophages in the untreated asthma group was lower than that in the normal control group. Huai qi huang alone or combined with budesonide increased the phagocytosis of alveolar macrophages compared with the normal control, untreated asthma and budesonid-treated asthma groups. The levels of IFN-γ in plasma and BALF were positively correlated with the phagocytosis of alveolar macrophages.</p><p><b>CONCLUSIONS</b>The levels of IL-4 and IL-17 increase and the IFN-γ level decreases in plasma and BALF, and the phagocytosis of alveolar macrophages decreases in asthmatic rats. Huai qi huang treatment may increase the IFN-γ expression in plasma and BALF and the phagocytosis of alveolar macrophages in asthmatic rats. There is a synergistic effect between huai qi huang and glucocorticoids.</p>

Relationship between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Sch-nlein purpura nephritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore possible correlations between renal Th1/Th2 ratio and renal microvascular injury in children with Henoch-Sch-nlein purpura nephritis (HSPN).</p><p><b>METHODS</b>Thirty-two children with HSPN were enrolled. They were classified into four groups by renal pathology: HSPN class II (n=8), HSPN class IIIa (n=7), HSPN class IIIb (n=10) and HSPN class IV/V (n=7). Five patients undergoing nephrectomy due to trauma were used as the controls. INFγ, IL-4 and CD34 in the renal tissues were measured by immunohistochemical analysis. INFγ was used as a marker of Th1, IL-4 was used as a marker of Th2 and CD34 was used as a marker of microvessel. The renal microvessel density was evaluated according to the Weidner standard. The relationships among the local Th1/Th2 ratio, renal pathological grade, microvessel score and microvessel density were studied.</p><p><b>RESULTS</b>Immunohistochemical analysis showed a lower expression of INFγ and a higher expression of IL-4 in the HSPN groups than in the control group. The local Th1/Th2 ratio in the HSPN groups decreased and correlated significantly with the renal pathological grade. There were significant differences among four HSPN subgroups (P<0.05). Compared with the control group, the renal microvessel density in the HSPN class II and class IIIa groups increased significantly (P<0.05), but it decreased in the HSPN class IV/V group (P<0.05). The renal microvessel scores in the HSPN class IIIa, class IIIb and class IV/V groups increased significantly compared with those in the control and the HSPN classⅡ. The increased renal microvessel scores were associated with more severe renal pathological changes. A negative correlation was found between the local Th1/Th2 ratio and the microvessel density in kidneys (r=-0.921, P<0.01).</p><p><b>CONCLUSIONS</b>The decrease of Th1/Th2 ratio in kidneys might be responsible for renal microvascular injury in children with HSPN.</p>

1,25(OH)(2)D(3) influences endothelial cell proliferation, apoptosis and endothelial nitric oxide synthase expression of aorta in apolipoprotein E-deficient mice / 中华儿科杂志

<p><b>OBJECTIVE</b>To study possible influences of 1,25(OH)(2)D(3) on endothelial cell proliferation, apoptosis and endothelial nitric oxide synthase (eNOS) expression of aorta in apolipoprotein E-deficient (apoE(-/-)) mice and to explore the relationship between vitamin D and atherosclerosis.</p><p><b>METHOD</b>Endothelial cell of aorta in apoE(-/-) mice were isolated and cultured, and the influence of 1,25(OH)(2)D(3) on endothelial cell proliferation were observed by MTT, apoptosis of cells were quantitated by terminal deoxynucleotidyl transferase mediated dUTP nick end labelling, Bcl-2 mRNA, fas mRNA and eNOS mRNA was detected by reverse transcription-polymerase chain reaction.</p><p><b>RESULT</b>Endothelial cell proliferation rate of aorta did not significantly change in the two control groups (0.162 ± 0.031 vs. 0.158 ± 0.006, P > 0.05). Compared with control groups, 1,25(OH)(2)D(3) stimulated endothelial cell proliferation of aorta (P < 0.05), but endothelial cell proliferation rate did not significantly change in different 1,25(OH)(2)D(3) concentration groups [1,25(OH)(2)D(3) concentration: 10(-4)mol/L, 10(-5) mol/L, 10(-6) mol/L, 10(-7) mol/L, 10(-8) mol/L, endothelial cell proliferation rate: 0.189 ± 0.013 vs. 0.285 ± 0.011 vs. 0.296 ± 0.026 vs. 0.284 ± 0.017 vs. 0.233 ± 0.010, P > 0.05]. 1,25(OH)(2)D(3) research concentration as chosen as 10(-6) mol/L. In 1,25(OH)(2)D(3) 10(-6) mol/L group, the expression of Bcl-2, eNOS mRNA was significantly increased (0.78 ± 0.16 vs. 0.46 ± 0.21 vs. 0.42 ± 0.17, 0.56 ± 0.16 vs. 0.39 ± 0.13 vs. 0.35 ± 0.11, 0.46 ± 0.2 vs. 10.42 ± 0.17 vs. 0.78 ± 0.16, 0.79 ± 0.21 vs. 0.81 ± 0.20 vs. 0.43 ± 0.12), apoptotic index, Fas mRNA was significantly decreased (15.14 ± 3.19 vs. 18.94 ± 4.22 vs. 19.27 ± 4.58, 0.43 ± 0.12 vs.0.79 ± 0.21 vs. 0.81 ± 0.20)(P < 0.05). The quantity of eNOS gene expression was inversely associated with apoptosis index and Fas mRNA, was positively associated with Bcl-2 mRNA (r = -0.676, -0.758, 0.762, P < 0.01).</p><p><b>CONCLUSION</b>1,25(OH)(2)D(3) stimulated endothelial cell proliferation, inhibited apoptosis and increased eNOS expression of aorta in apoE(-/-) mice. These results may deepen understanding of the pathogenesis of atherosclerosis.</p>

Relationship of 24-hour ambulatory blood pressure and rennin-angiotensin-aldosterone system in children with primary nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes of blood pressure by 24-hour ambulatory blood pressure (ABP) monitoring in children with primary nephrotic syndrome (PNS) and explore the relationship of the changes in blood pressure with rennin-angiotensin-aldosterone system (RAAS) in these children.</p><p><b>METHODS</b>ABP and casual blood pressure (CBP) monitoring were performed in 114 children with PNS. Plasma levels of rennin activity (PRA), angiotensin II (AngII) and aldosterone (ALD) were measured. The correlation of plasma levels of PRA, AngII and ALD with ABP was evaluated.</p><p><b>RESULTS</b>Of the 114 children with PNS, 101 (88.6%) presented elevated blood pressure. Mild or severe masked hypertension was found in 45 children (39.5%). Eighty (70.2%) children showed non-dipper blood pressure. The index and load of systolic blood pressure were higher than those of diastolic blood pressure. The blood pressure index and blood pressure load during sleep were higher than those during wakefulness. The boy presented higher diastolic blood pressure index and load than girls. Decubitus blood PRA, AngII and ALD levels in children with PNS were significantly higher than normal controls. The group with elevated blood pressure presented significantly higher decubitus blood PRA, AngII and ALD levels than the group with normal blood pressure. AngII level was significantly positively correlated with the index and load of both systolic blood pressure and diastolic blood pressure.</p><p><b>CONCLUSIONS</b>The children with PNS present a high incidence of hypertension, with a large percentage of masked hypertension and non-dipper blood pressure. Systolic blood pressure increases more significantly than diastolic blood pressure. Blood pressure during sleep increases more significantly than that during wakefulness. Diastolic blood pressure increases more significantly in boys than in girls. RAAS activity is elevated and the elevated RAAS activity might increase the blood pressure mainly by AngII in children with PNS.</p>

Protective effects of catechin on apoptosis of endothelial progenitor cells induced by H2O2 in rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of H2O2 on the proliferation and apoptosis of endothelial progenitor cells (EPCs) and the antogonistic effects of catechin on the cell apoptosis induced by H2O2 in rats.</p><p><b>METHODS</b>Immuno-fluoreascence assay was applied to detect CD34, CD133 and VEGFR-2 expression. EPCs of generation 2 were divided into control cells, H2O2-treated cells and catechin-H2O2-treated cells (H2O2: 100 mg/L; catechin: 10 mg/L). Genomic DNA was extracted by the conventional method after intervention for the analysis of apoptosis ladder pattern. The MTT assay was applied to detect proliferation rate of EPCs.</p><p><b>RESULTS</b>The cultured cells at day 10 expressed CD34, CD133 and VEGFR-2. DNA apoptosis ladder pattern appeared in H2O2-treated cells 2 days after intervention. After 3 days of intervention DNA apoptosis ladder pattern appeared in both H2O2-treated cells and H2O2-catechinjtreated cells, with more ladders and grayer scale in H2O2 -treated cells. Compared with the controls, H2O2-treated cells and H2O2-catechin-treated cells showed significantly decreased proliferation rate (p<0.01), with the lowest proliferation rate at the 2nd day (p<0.05). The H2O2-catechin-treated cells showed increased proliferation rate than H2O2-treated cells at the 1st, 2nd and 3rd days.</p><p><b>CONCLUSIONS</b>H2O2 may impair EPCs proliferation and induce EPCs apoptosis. Catechin may increase the capacity of EPCs for the resistance to apoptosis induced by H2O2.</p>

Effects of clearance of superoxide anion by catechin on the expression of NO and eNOS and apoptosis in endothelial progenitor cells induced by angiotensin II / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of clearance of superoxide anion by catechin on the expression of nitrogen monoxidum (NO) and endothelial nitricoxide synthase (eNOS) and apoptosis in endothelial progenitor cells (EPCs) induced by angiotensin II (Ang II).</p><p><b>METHODS</b>The marrow endothelial progenitor cells of Sprague-Dawley rats were isolated and assigned to control (no treatment), Ang II treatment and Ang II + catechin treatment groups. After 48 hrs of culture, the concentration of O2*- in the supernate was measured by the NBT method, and NO concentration in the supernate was measured by the nitrate reductase method; the apoptosis rate of EPCs was detected by the TUNEL method; the mRNA expression of eNOS was detected by RT-PCR; the protein expression of eNOS was detected by Western blot analysis.</p><p><b>RESULTS</b>Ang II of 10-6 mol/L was determined as the suitable concentration for cell induction by the MTT test. Catechin of 400 mg/L was determined as an advisable intervention dosage. The apoptosis rate of EPCs in the control, the Ang II and the Ang II+catechin treatment groups were 2.48+/-0.12%, 54.18+/-0.77% and 16.87+/-0.35%, respectively, and there were significant differences among the three groups (P<0.01). The O2*- concentration in the Ang II and the Ang II+catechin treatment groups (81.7+/- 3.6 and 62.3+/- 2.2 U/L respectively) was significantly higher than that in the control group (33.7+/- 2.8 U/L) (P<0.01). An increased NO concentration was also found in the Ang II (189. 8+/- 9.0 micromol/L) and the Ang II+catechin treatment groups (276.4+/- 10.1 micromol/L) compared with that in the control group (105.8+/- 9.8 micromol/L) (P<0.01). There were significant differences in the concentrations of O2*- and NO between the Ang II and the Ang II+catechin treatment groups (P<0.05). The mRNA (P<0.05) and protein expression (P<0.01) of eNOS in the Ang II and the Ang II+catechin treatment groups increased significantly compared with those in the control group. The Ang II+catechin treatment group showed increased eNOS protein expression compared with the Ang II group (P<0.05).</p><p><b>CONCLUSIONS</b>Ang II may induce the generation of O2*-, inactivate NO and increase gene and protein expression of eNOS in EPCs. Catechin might decrease the apoptosis of EPCs through the effective clearance of O2*-and the reduction of NO inactivation and of eNOS protein uncoupling.</p>

Expression of vascular endothelial growth factor is related to microvessel injury of renal interstitium in children with Henoch Schönlein purpura nephritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between vascular endothelial growth factor (VEGF) expression and microvessel injury of renal interstitium in children with Henoch-Schönlein purpura nephritis (HSPN).</p><p><b>METHODS</b>Thirty-two children with HSPN and who had not received glucocorticoid or immunodepressants treatment before hospitalization were enrolled. Five children undergoing nephrectomy due to renal trauma were used as the control group. Renal samples were stained by hematoxylin and eosin and renal pathological changes were evaluated semi-quantitatively. CD34 and VEGF expression was detected by immunohistochemistry. CD34 was used as the marker for endothelial cells of renal microvessels. The microvessel density (MVD) was calculated by CD34 immunostaining.</p><p><b>RESULTS</b>Compared with the control and the renal pathological grade II HSPN groups, MVD in the grade III and above HSPN groups decreased significantly, with an obvious reduction in MVD with the increased renal pathological grade (p<0.05). The renal microvessel score in the grades IIIa, IIIb, IV, and V HSPN groups decreased obviously compared with that in the control group. The renal microvessel score decreased with the increased renal pathological grade (p<0.05). VEGF expression in the grade II HSPN group was higher (p<0.05), while that in the grades IV and V HSPN group was lower than that in the control group (p<0.05). VEGF expression in the HSPN group showed a significant reduction with the increased renal pathological grade (p<0.05). There was a positive correlation between VEGF expression and MVD in renal tissue in the HSPN group (r=0.935, p<0.01).</p><p><b>CONCLUSIONS</b>The decreased expression of VEGF may be responsible for the renal pathological damage and microvessel injury in HSPN.</p>

Relationship between impulsivity and sleep disorders in children aged 6 to 12 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between impulsivity and sleep disorders in children.</p><p><b>METHODS</b>A total of 1 736 children at ages of 6 to 12 years were randomly sampled from five districts of Changsha. Their parents completed the questionnaires about children's sleep conditions and behaviors (using Barratt Impulsiveness Scale 11th version).</p><p><b>RESULTS</b>Five hundred and fifty-four children (31.9%) had sleep disorders. The incidence of sleep disorders in boys was significantly higher than that in girls (35.4% vs 28.3%; P<0.01). The scores of attentional, motor, and non-planning impulsiveness factors as well as the total score of Barratt Impulsiveness Scale in children with sleep disorders were significantly higher than those in children without (P<0.01). The incidence of daytime sleepiness (35.9%) in children with sleep disorders was significantly higher than that in children without (24.7%; P<0.01). The scores of attentional, motor, and non-planning impulsiveness factors increased with the grade of sleep disorders, and reached a peak at the fifth grade. The children with frequent sleep snoring showed higher scores of above three impulsiveness factors than children without sleep snoring or having rare snoring (P<0.01).</p><p><b>CONCLUSIONS</b>Sleep disorders are associated with impulsivity in children. It is thus essential to pay close attentions to children's sleep for children with relatively high impulsiveness.</p>

Preliminary analysis of urinary proteomics in children with steroid-resistant and steroid-sensitive nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study and identify the protein markers in the urine of children with steroid-sensitive (SSNS) and steroid-resistant nephrotic syndrome(SRNS).</p><p><b>METHODS</b>Total urinary proteins were extracted from children with SSNS before and after steroid therapy, SRNS, and healthy children (n=5 in each group). Urinary proteins were separated by immobilized pH gradient based on two-dimensional gel electrophoresis (2-DE). The silver-stained 2-DE gels were scanned with digital Image Scanner and analyzed with Image Master 2-DE Elite 3.01 software. Peptide mass fingerprint (PMF) of differential protein spots was obtained with MALDI-TOF-MS. Proteins were identified by Mascot software based on NCBI protein database.</p><p><b>RESULTS</b>There were 66 spots with different expression of protein between SRNS children and SSNS children before steroid therapy, and 24 spots and 27 spots only occurred in SRNS children and SSNS children before steroid therapy, respectively. There were 75 spots with different expression of protein between SSNS children after steroid therapy and healthy controls, and 11 spots only occurred in SSNS children after steroid therapy. Eighteen protein spots with different expression (6 spots in each nephrotic group) were chose and analyzed by MALDI-TOF-MS, and 9 types of proteins were identified.</p><p><b>CONCLUSIONS</b>Nine types of urinary proteins with different expression (6 spots in each nephrotic group) were identified between SRNS and SSNS children, and they might be the biomarkers for SRNS or SSNS.</p>

A prospective multicenter clinical control trial on treatment of refractory nephrotic syndrome with mycophenolate mofetil in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of mycophenolate mofetil (MMF) plus prednisone on refractory nephrotic syndrome (RNS) in children.</p><p><b>METHODS</b>One hundred and forty-two children with RNS from ten clinical trial centers were divided into two groups: MMF (n=87) and control (n=55). The MMF group patients were administered with oral MMF (30-40 mg/kg daily) for at least 6 months. Afterwards the patients who responded to MMF received another 6 months MMF treatment at a dosage of 10-20 mg/kg daily. The controls were treated with pulse intravenous infusion of cyclophosphamide (CTX) (10 mg/kg daily) for 2 days every 2 weeks for 3 months. Then CTX was administered at a dosage of 500 mg/m2 once a month 4, 7 and 10 months after treatment. While the patients received MMF or CTX treatment, they were treated with oral prednisone (0.5-1 mg/kg daily) for 2 to 3 months, and then the dosage of prednisone was gradually reduced. Urinary protein, liver and renal functions, and side effects of drugs were examined at regular intervals for one year.</p><p><b>RESULTS</b>Of the 87 patients, 58 achieved complete remission, 16 achieved partial remission, 9 achieved early remission and 4 had no response to treatment. In the control group, 35 achieved complete remission, 9 achieved partial remission, 1 achieved early remission and 10 had no response to treatment. The total remission rate in the MMF group (95.4%) was significantly higher than that in the control group (81.8%) (P<0.01). After treatment 67 patients (65.4%) in the MMF group had negative proteinuria compared with 36 patients (65.4%) in the control group (P>0.05). MMF was found to be more effective in reducing proteinuria, and improving hypoproteinemia, oliguria, hyperlipemia, and edema than CTX. MMF was better tolerated with lower incidences of adverse reactions than CTX.</p><p><b>CONCLUSIONS</b>The combined therapy of MMF and prednisone is more effective and tolerable than pulse intravenous infusion of CTX for treatment of RNS in children.</p>

Effects of astragalus on renal tubulointerestitial lesions and expression of NF-kappaB and MCP-1 in renal tissues in rat experimental IgA nephropathy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of astragalus on tubulointerstitial lesions in rats with IgA nephropathy (IgAN) and to explore the possible mechanism.</p><p><b>METHODS</b>Twenty-eight Sprague-Dawley rats were randomly assigned to three groups. The rat model of IgA nephropathy was induced by intragastric administration of bovine serum albumin and injections of LPS and CC14. Six weeks later, the rats with IgAN were randomly treated with oral astragalus (3 g/kg/d, for 6 weeks) or normal saline. Normal control rats which were not subjected to IgAN were treated with normal saline. The number of urinary erythrocytes and urinary protein and B-D-N-Acetyl glucosaminidase (NAG) contents were determined by Pan-automatic biochemistry analyzing meter. Expression of monocyte chemotactic protein-1 (MCP-1) and nuclear factor-kappa B (NF-kappaB) in tubulointerstitial tissues were analyzed by immunohistochemistry. A semiquantitative score was used to evaluate the degree of renal pathologic lesions.</p><p><b>RESULTS</b>The number of urinary erythrocytes (74.02+/-16.58 / microL vs 383.23+/-4.94 /microL) and urinary protein (13.88+/-4.94 vs 59.82+/-14.73 mg/L) and NAG contents (2.84+/-0.31 vs 5.24+/-0.80 U/L) in the astragalus-treated IgAN rats decreased remarkably compared with those in the IgAN rats without astragalus treatment (P<0.01). Expression of the NF-kappaB and MCP-1 in the renal tissues in the IgAN rats without astragalus treatment was significantly higher than that in the astragalus-treated IgAN rats and normal control rats (P<0.01). There were significant differences in the scores of renal pathologic lesions between the IgAN rats with or without astragalus treatment (6.03+/-0.46 vs 10.57+/-1.23; P<0.01).</p><p><b>CONCLUSIONS</b>Astragalus can decrease the number of urinary erythrocytes and urinary protein and NAG contents, and relieves tubulointerstitial lesions, possibly through the down-regulation of NF-kappaB and MCP-1 expression in rats with IgAN.</p>