Baseline left ventricular ejection fraction associated with symptom improvements in both children and adolescents with postural tachycardia syndrome under metoprolol therapy / 中华医学杂志(英文版)

BACKGROUND@#Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient's physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS.@*METHODS@#This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of  0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013).@*CONCLUSIONS@#Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.

Prediction of quality markers of traditional Chinese medicines based on network pharmacology / 中草药·英文版

Network pharmacology is a powerful tool to reflect the pharmacologically active effects, mechanism of action and toxic activity of traditional Chinese medicines (TCMs). The ingredients of TCMs, associated with quality control of TCM products, are those fundamental chemicals that exhibit biological activities. A great amount of effort has been made by scientists in that field in order to improve the quality of TCMs, though the approaches to determine their quality and the TCM theory and compatibility rules remain ambiguous. Now some methods and technologies must be applied to predict and explore the quality marker (Q-marker) for quality control, as well as to clarify the factors affecting the quality of TCM, which may give new insight into rational ground of establishment of appropriate quality control and assessment system. In this review paper, authors focus on the prediction of quality markers of TCMs by network pharmacology based on three aspects: (1) from network medicine to network pharmacology, (2) complex network system of traditional Chinese medicine, and (3) predicting TCM quality markers based on network pharmacology. Authors proposed the research pattern on network pharmacology based on biological and medical networks, and further TCM network pharmacology based on substantial basis of TCM formulae, and the idea of “effect-ingredient-target-fingerprint” to predict and recognize the TCM Q-marker was the ultimate goal. In addition, authors yet noted how to make full use of the advantages of network toxicology to provide new ideas for the toxicity study of complex TCM systems and the prediction of TCM toxicity markers.

Preformulation study on antirheumatic drug DK-507 / 国际药学研究杂志

Objective To perform a preformulation study for a new antirheumatic drug DK-507 so as to provide theoretical basis for its preparation research.Methods The appearance,crystal form and solubility of DK-507 were investigated.A high perfor-mance liquid chromatography(HPLC)method for the quantitative determination of DK-507 was established.The apparent oil/water (O/W)partition coefficient of DK-507 and the equilibrium solubility of the drug under different pH conditions were determined. Re-sults DK-507 is a white crystalline powder,which is odorless,tasteless and insoluble in water.The quantitative HPLC method for the DK-507 determination showed a good linearity in the range of 10-80 μg/ml(R=0.9998).The apparent O/W partition coefficient of DK-507 was determined to be 1.80.In the different pH solutions,the solubility of DK-507 showed a W-form change,with poor solubili-ties in lower pH solutions,which showed a gradient improvement with the increase of the solution pH values.Conclusion The quanti-tative HPLC method for the DK-507 determination,established in this study,is accurate and reliable.The present results indicate that DK-507 is a water-insoluble drug,and according to the O/W partition coefficient,DK-507 seems likely to be prepared into oral solid preparations.

A study on the degradation of anti-influenza drug GZ830 / 国际药学研究杂志

Objective To establish an HPLC method for the determination of anti-influenza drug GZ830 and its related substances, and investigate the degradation of GZ830. Methods The degradation of GZ830 under the conditions with different pH and temperatures was investigated with HPLC method to explore the degradation principle. Results The HPLC method for the determination of GZ830 was established. The linear relationship between the drug and the peak area was good in the concentration range of 160-1200 μg/ml (r=0.9998). GZ830 was easily degraded under alkaline conditions and could not tolerate high temperatures. The degradation of GZ80 did not occur when its aqueous solution was kept at 40℃ for 6 h. However, after heating at 80℃ for 6 h, about 2.4％GZ80 was degraded and the degradation rate reached about 7％ after kept at 115℃ for 30 min. Conclusion Under the optimized chromatographic conditions, GZ830 was well separated from the degraded products, and the HPLC method possessed high sensitivity and good specificity for the determination of GZ80, and the degradation of GZ80 was different under different conditions.

Preformulation study on novel antiviral drug GZ914 / 军事医学

Objective To study the physical-chemical parameters of antiviral drug GZ 914 and provide data for the preparation design .Methods The appearance , crystal structure and solubility of GZ 914 were investigated .An HPLC method was established to determine the content of GZ 914 in vitro before oil/water partition coefficient and solubility in different pH experiments were calculated .Results GZ914 was a straw yellow powder with a crystalline structure , low water-solubility and good lipotropy .The HPLC method had a good linear relationship within the range of 12-60 μg/ml (r=0.9998).The oil/water partition coefficient of GZ914 was 1.9.Conclusion This analytical method is accurate and reliable.The oil/water partition coefficient indicates that the drug could be formulated as an oral solid preparation.

Quality-of-life outcomes of the patients with tongue cancer following reconstruction with free forearm flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the quality-of-life outcomes in patients with tongue cancer following reconstruction with free forearm flap.</p><p><b>METHODS</b>Quality-of-life (QOL) outcomes of 112 patients of tongue reconstruction with free forearm flap were assessed using University of Washington head and neck QOL questionnaire (UW-QOL). The QOL outcomes of the patients with different defect range and site were also compared.</p><p><b>RESULTS</b>The overall mean QOL scores of the 112 patients was 959.6, which reached about 80% (960/1200) of the overall score. The QOL scores of the patients with defects not more than 1/2 tongue (more than 1/3 tongue) were significantly higher than those with defects more than 1/2 tongue (P < 0.05). There was no significant difference between the QOL scores of the patients with and without tongue base defect (P > 0.05).</p><p><b>CONCLUSIONS</b>Free forearm flap is a good choice for tongue reconstruction and more suitable for the reconstruction of the defects not more than 1/2 tongue (more than 1/3 tongue).</p>

Effect of selective alpha1 receptor agonist in the treatment of children with postural orthostatic tachycardia syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>The study was designed to examine the effect of selective alpha1 receptor agonist midodrine hydrochloride in the treatment of children with postural orthostatic tachycardia syndrome.</p><p><b>METHODS</b>Fifty-five children (23 male, 32 female, age 5 - 19 yrs, mean age 12.3 +/- 3.1 yrs) who came from Peking University First Hospital were included in the study and clinical investigations as well as standing test, basic head-up tilt test and sublingual nitroglycerin-provocated head-up tilt test under quiet circumstance were conducted. They were randomly divided into treatment group (with midodrine hydrochloride and oral rehydration salt treatment) and control group (with oral rehydration salt treatment only). At last, the disease-free rate, improvement rate and effective rate of symptoms, and the rate of HUT from positive to negative response were compared between control group and treatment group. SPSS 10.0 software was used for the statistical analysis of these data.</p><p><b>RESULTS</b>The symptom improvement rate in treatment group was significantly higher than that of control group after three and six weeks of treatment (100.0% vs. 42.4%, P < 0.001; 100.0% vs. 42.4%, chi2 = 19.352, P < 0.001). The disease-free rate at follow-up end-point in treatment group was significantly higher than that of control group (77.3% vs. 27.3%, chi2 = 13.239, P < 0.001). The effective rate at follow-up end-point in treatment group was also significantly higher than that of control group (100.0% vs. 36.4%, chi2 = 22.647, P < 0.001). The rate of HUT changing from positive to negative response between two groups after three weeks of treatment was not significantly different (31.8% vs. 12.1%, P > 0.05), but it was significantly different (81.0% vs. 48.5%, P < 0.05) after six weeks of treatment.</p><p><b>CONCLUSION</b>Selective alpha1 receptor agonist midodrine hydrochloride is effective in the treatment of children with postural orthostatic tachycardia syndrome.</p>

Reviews on antiviral activity of chemical constituents from plants / 中国中药杂志

This paper reviewed the progress in researches on antiviral activity of chemical constituents from plants in recent years, the antiviral activity and mechanism of action of flavonoids, alkaloids, terpenoids, coumarins and polysaccharoses were sammarszed, provided new leading compound for antivirus new drugs from the plares in prospect.

A multicenter study on treatment of autonomous nerve-mediated syncope in children with beta-receptor blocker / 中华儿科杂志

<p><b>OBJECTIVE</b>Syncope is a common pediatric emergency. Based on an epidemiologic survey in the USA, around 15% of children experienced syncopal attack, which strongly influenced the life, study and hurt the children mentally and physiologically. Therefore, exploring the therapeutic regimen has become a hot topic in the field of pediatric cardiology. The aim of this study was to examine the effect of beta receptor blocker in the treatment of children with autonomous nerve mediated syncope.</p><p><b>METHODS</b>Totally 103 children (43 males, 60 females, age 5 - 19 yrs, median 12.0 +/- 2.6 yrs) with autonomous nerve mediated syncope from Beijing, Hunan, Hubei and Shanghai, were included in this study. Forty-nine of them suffered from vasovagal syncope (VVS) and 54 suffered from postural tachycardia syndrome (POTS). They were randomly divided into treatment group accepting oral metoprolol treatment and control group accepting oral rehydration salt treatment. The frequency of syncopal episodes and the outcome of head-up tilt (HUT) test were observed. SPSS 10.0 software was used for the statistical analysis of these data.</p><p><b>RESULTS</b>The cure rate of children who suffered from VVS and POTS and took oral metoprolol was 60.61% and 68.75%, respectively, but in the control group, the cure rate was only 18.75% and 0.00%, respectively. The rate of improvement of children who suffered from VVS and POTS and were treated with oral metoprolol was 15.15% and 15.63%, respectively, and in the control group, it was 6.25% and 40.91%, respectively. The effective rates for cases of VVS and POTS treated with oral metoprolol were higher than those of cases received oral rehydration salt treatment (P < 0.01). The percentage of the change from positive HUT to negative for children with VVS and POTS who took oral metoprolol therapy was 60.61% and 68.75%, respectively, but in control group, it was only 18.75% and 9.09%, respectively (P < 0.01). There was a significant difference in the percentage of the change from positive HUT to negative between children with VVS treated with oral metoprolol and with oral rehydration salt (P < 0.01). Also, a significant difference was found in the percentage of the change from positive HUT to negative between children with POTS treated with oral metoprolol and with oral rehydration salt (P < 0.01).</p><p><b>CONCLUSION</b>beta receptor blocker is effective in the treatment of children with VVS or POTS.</p>

Investigation of Tilt Angle of Head-Up Tilt Test on Children / 实用儿科临床杂志

0.05).The different tilt angles impacted patients' fear psychology(?2=8.038,P=0.018).The order of the extent of children's fear psychology represented from low to high at the angle of 60?,70? and 80?,respectively.The extent of the children's fear psychology had positive correlation with the tilt angle(r=0.669,P=0.002).Conclusions The tilt test angle does not affect the positive rate of HUTT and the hemodynamics in children undergoing HUTT with angles from 60? to 80?.The children at the tilt angle 60? had less fear than at the angle of 70? or 80?.The 60? tilt angle of HUTT in children is recommended in the clinical practice.

A multi-center study of hemodynamic characteristics exhibited by children with unexplained syncope / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Syncope is common in children and adolescents, with 15% estimated to have had at least one syncopal episode by age 18. In recent years, an increasing number of children, especially girls at their school age, have developed unexplained syncope. The mechanism of an unexplained syncope exhibited by children is incompletely studied; the association between different hemodynamic patterns and clinical features is also not clear. The aim of the study was to investigate the hemodynamic patterns of children with unexplained syncope and to examine the clinical relevance.</p><p><b>METHODS</b>Two hundred and eight children [87 boys, 121 girls, aged 3 - 19 years, mean (11.66 +/- 2.72) years] were selectively recruited from May 2000 to April 2006 when they presented syncope as their main complaint at the Multi-center Network for Childhood Syncope in Beijing, Hunan Province, Hubei Province, and Shanghai of China. All of the patients underwent head-up tilt tests; data were analyzed using SPSS version 10.0 for Windows. Continuous variables were expressed as the mean +/- standard deviation. Dichotomous variables were compared through a chi(2) test. A value of P < 0.05 (two sided) was regarded as statistically significant.</p><p><b>RESULTS</b>The age distribution of children with syncope was approximately normal. Head-up tilt tests was positive in 155 children, and the incidence of positive response of the baseline head-up tilt test for diagnosing unexplained syncope was 50.48%. The sensitivity value and diagnostic value of sublingual nitroglycerin head-up tilt test were both 74.52%. The hemodynamic pattern was normal in 53 children. The 155 children, who were positive in head-up tilt tests, showed signs of postural orthostatic tachycardia syndrome (60, 28.8%), the vasoinhibitory pattern (72, 34.6%), the cardioinhibitory pattern (5, 2.4%), and the mixed pattern (18, 8.7%). The gender distribution between the two age groups (age < 12 years vs age > or = 12 years) was not different (P > 0.05). The distribution of hemodynamic patterns between the children of the two age groups (age < 12 years vs age > or = 12 years), and the children with different complaints (dizziness vs syncope) was significantly different (P < 0.05), while the distribution between the children of different sexes and different lasting time of syncope (< or = 5 minutes vs > 5 minutes) was not significantly different (P > 0.05). Different hemodynamic patterns were differentiated by differing syncope inducements, presymptoms, and complicated symptoms during and after syncope.</p><p><b>CONCLUSION</b>The tested girls were more prone when compared with the boys to have unexplained syncope, and the peak age was around twelve years old. The incidence of positive response of head-up tilt tests was also relatively higher for the girls. The distribution of hemodynamic patterns for different ages was different. For children with unexplained syncope, we should use head-up tilttests to distinguish the hemodynamic patterns in order to adopt rational therapeutic measures.</p>

A study on atrioventricular annular movement in healthy children by tissue Doppler imaging / 中华儿科杂志

<p><b>OBJECTIVE</b>Detecting the atrioventricular annular velocity along the long axis of ventricle by tissue Doppler imaging (TDI) is a useful modality to quantitatively assess global myocardial function. The present study was designed to quantitatively assess ventricular function in healthy children by TDI and to evaluate the clinical effect of growth and echocardiographic parameters on TDI velocities during childhood.</p><p><b>METHODS</b>The study enrolled 242 healthy children aged 3 days to 17 years and they were divided into 8 groups: < 1 month of age group (37 cases), 1 month-of age group (28 cases), 7 months-of age group (21 cases), 1 year-of age group (36 cases), 4 years-of age group (40 cases), 7 years-of age group (26 cases), 10 years-of age group (28 cases) and > or = 13 years of age group (26 cases). Pulsed wave TDI velocities were obtained at the lateral mitral annulus (MA-L), basal septum (MA-S) and lateral tricuspid annulus (TA) during ventricular systole (Sa), early diastole (Ea) and late diastole (Aa), and Ea/Aa and E/Ea were obtained. Conventional echocardiography performed done and the parameters of left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), the transmitral and transtricuspid flow E wave and A wave velocities and E/A ratio were obtained. TDI parameters were compared with demographic and echocardiographic variables.</p><p><b>RESULTS</b>Sa, Ea and Ea/Aa were the lowest in children < 1 month of age [MA-L: Sa (4.8 +/- 0.7) cm/s, Ea (6.6 +/- 1.1) cm/s; MA-S: Sa (4.1 +/- 0.6) cm/s, Ea (5.0 +/- 0.8) cm/s; TA: Sa (6.2 +/- 1.2) cm/s, Ea (6.4 +/- 1.0) cm/s], and increased with age. The increase was significant from 1 month- to 1 year-of age group 1 year-of age group: MA-L: Sa (8.5 +/- 2.0) cm/s, Ea (16.3 +/- 2.6) cm/s; MA-S: Sa (7.2 +/- 0.8) cm/s, Ea (12.2 +/- 1.6) cm/s; TA: Sa (12.6 +/- 2.3) cm/s, Ea (14.7 +/- 2.6) cm/s. Ea and Sa of TA reached the older children's value earlier than those of the mitral annulus did. Aa increased in the 1 month-of age group compared to < 1 month of age group and remained stable beyond 1 year-of age group. Mitral annulus E/Ea ratio was high among neonates to 7-months-old children (MA-L: 9.2 +/- 2.1, MA-S: 12.1 +/- 2.9), and decreased with age, and there was a significant decrease in 1 year-of age group (MA-L: 5.9 +/- 1.2, MA-S: 7.8 +/- 1.3). In these healthy children, all the above TDI parameters except Aa were influenced by age, body surface area (BSA), LVEDD and heart rate. The influence of age and BSA showed a logarithm model. LVEDD was the main factor that influenced Sa and Ea of MA-L and MA-S, and it was the only single factor that influenced E/Ea ratio at mitral annulus.</p><p><b>CONCLUSIONS</b>This study demonstrated that the left and right ventricular function developed with age in childhood, and it developed most rapidly during infancy and toddler period. The right ventricular function matured earlier than that of the left ventricle. Cardiac growth, age, and heart rate had important clinical effects on TDI velocities during childhood, and LVEDD had the most important influence on left ventricular systolic and diastolic function.</p>

Up-regulation of costimulatory molecules by sodium butyrate in acute leukemia cells and its molecular mechanism / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the effect of sodium butyrate (SB) on the expression of costimulatory molecules in acute leukemia cells and its mechanism.</p><p><b>METHODS</b>The expression of CD86 and CD80 was examined on the surfaces of NB4, HL-60, Kasumi-1, U937 and Jurkat cells by flow cytometric analysis after treated by SB or not. Allogeneic mixed lymphocyte reaction was used to evaluate the immunomodulatory effects of cells treated by SB. Activated NF-kappaB was measured with an NF-kappaB assay kit.</p><p><b>RESULTS</b>Up-regulation of CD86 and CD80 at various levels was observed on these leukemia cells treated by SB. The ratio of CD86 expressing cell in NB4 cells treated by 0.5 mmol/L SB was 36.8 times higher than that in control. Up-regulation of NF-kappaB was similar to that of CD86. Allogeneic lymphocyte proliferation was strongly stimulated by the SB treated cells.</p><p><b>CONCLUSION</b>SB can improve the expression of CD86 in acute leukemia cells. NF-kappaB was an important transcription factor involved in the up-regulation of CD86.</p>

Characteristics and Clinical Features of Positive Response for Head - Up Tilt Test in Children / 实用儿科临床杂志

Objective To study the characteristics and clinical features of positive response during head - up tilt test (HUT) in children. Methods Forty- nine cases of syncope and aura of syncope were included in the study. All of them underwent HUT (tilt angle 60 degree,lasting 45 minutes). During the test,children' blood pressure,heart rate.electrocardiography and clinical symptoms and signs were dynamically observed. Results The common syncope aura symptoms were headache, dizziness, chest distress, difficulties in breathing, pale, perspiration, blurred vision, auditus depression and symptoms related to digestive symptoms. Among the 28 positive cases, 7 cases were of vaso - inhibitory pattern (25%), with a decrease in blood pressure and an increase in heart rate, 3 cases inhibitory pattern (11%), with a decrease in heart rate but withoilt'blood pressure changes, 4 cases mixed pattern (14 %), with decreases in heart rate and blood pressure obviously, 10 eases POTS (36%), with an increase in heart rate by 30 bpm or up to 120 bpm within 10 minutes while testing, and 4 cases orthostatic hypotension (14%), with a decrease in blood pressure within 3 minutes. Conclusion HUT can be regarded as the main tool in differential diagnosis of unexplained syncope in children.

Effect of Hyperlipidemia on Carotid Artery Wall Elasticity in Children / 实用儿科临床杂志

Objective To investigate the factors influencing the wall elasticity of carotid artery and the effect of hyperlipidemia on carotid artery elasticity in children.Methods Fifty-seven healthy children and 23 children with hyperlipidemia matched for age and sex were involved in the study.The pressure-strain elastic modulus(E?),stiffness parameter(?) and arterial compliance(AC) of carotid artery were measured by Aloka echo-tracking system.Correlations between age,blood pressure and E?,?,AC were analyzed in healthy children,respectively.Results In healthy children,age,systolic blood pressure and pulse pressure were positively correlated with E? and ?,and negatively correlated with AC.E? and ? significantly increased in children with hyperlipidemia compared to those in healthy children,and AC obviously decreased.Conclusions Hyperlipidemia might decrease the wall elasticity of carotid artery in children.Age and blood pressure are also factors affecting carotid artery elasticity in children.J Appl Clin Pediatr,2006,21(3):142-143

Assessment of Tissue Doppler Imaging on Function of Neonatal Ventricle in Early Stage of Neonatal Period / 实用儿科临床杂志

Objective To assess ventricular function of early stage neonates of different gestational ages by tissue doppler imaging(TDI).Methods Pulsed wave TDI velocities were obtained in 36 cases of premature infants with gestational ages of 32 to 36 weeks(premature group) and 33 cases of full-term infants(full-term group) aged 3 to 7 days at the lateral mitral annulus(MA),basal septum,and lateral tricuspid annulus(TA) during ventricular systole(Sa),early diastole(Ea),late diastole(Aa).Tansmitral and transtricuspid inflow were also obtained through pulsed doppler echocardiography.Results Ea and Sa in all of 3 locations were lower in the premature group compared with that of the full-term group,and Ea/Aa in TA was lower in premature group,but Aa and E/Ea showed no difference between 2 groups.Ea and Sa showed a positive correlation with gestational age and birth weight.Conclusions Ventricular systolic and diastolic function in premature infants are poorer than that in full-term infants in the early stage of neonatal period,and ventricular function is related to intra-uterus growth and maturity of the newborn.Diastolic function of the left ventricle in both groups develops rapidly during the early stage of neonatal period.