Effect of recombinant human growth hormone on serum Klotho and fibroblast growth factor 23 in children with idiopathic short stature / 中国当代儿科杂志

OBJECTIVES@#To investigate the changes in the serum levels of Klotho, fibroblast growth factor 23 (FGF23), and insulin-like growth factor-1 (IGF-1) in children with idiopathic short stature (ISS) before and after recombinant human growth hormone (rhGH) treatment, as well as the correlation of Klotho and FGF23 with the growth hormone (GH)/IGF-1 growth axis in these children.@*METHODS@#A prospective study was conducted on 33 children who were diagnosed with ISS in the Department of Pediatrics, Hebei Provincial People's Hospital, from March 10, 2021 to December 1, 2022 (ISS group). Twenty-nine healthy children, matched for age and sex, who attended the Department of Child Healthcare during the same period, were enrolled as the healthy control group. The children in the ISS group were treated with rhGH, and the serum levels of Klotho, FGF23, and IGF-1 were measured before treatment and after 3, 6, and 9 months of treatment. A correlation analysis was conducted on these indexes.@*RESULTS@#There were no significant differences in the serum levels of IGF-1, Klotho, and FGF23 between the ISS and healthy control groups (P>0.05). The serum levels of Klotho, FGF23, and IGF-1 increased significantly in the ISS group after 3, 6, and 9 months of rhGH treatment (P<0.05). In the ISS group, Klotho and FGF23 levels were positively correlated with the phosphate level before treatment (P<0.05). Before treatment and after 3, 6, and 9 months of rhGH treatment, the Klotho level was positively correlated with the IGF-1 level (P<0.05), the FGF23 level was positively correlated with the IGF-1 level (P<0.05), and the Klotho level was positively correlated with the FGF23 level (P<0.05), while Klotho and FGF23 levels were not correlated with the height standard deviation of point (P>0.05).@*CONCLUSIONS@#The rhGH treatment can upregulate the levels of Klotho, FGF23, and IGF-1 and realize the catch-up growth in children with ISS. Klotho and FGF23 may not directly promote the linear growth of children with ISS, but may have indirect effects through the pathways such as IGF-1 and phosphate metabolism. The consistent changes in Klotho, FGF23 and IGF-1 levels show that there is a synergistic relationship among them in regulating the linear growth of ISS children.

Spermine attenuates high glucose-induced myocardial fibrosis by regulating the cell cycle / 中国应用生理学杂志

To investigate the protective effect of spermine (Sp) on diabetic cardiomyopathy (DCM) and high glucose-induced cardiac fibroblasts (CFs), and to explore its mechanism. ①Animal experiments: 24 male Wistar rats were randomly divided into control group, type 1 diabetes group (TID) and spermine group (TID+Sp, each group n=8). TID rats were induced by streptozocin (STZ, 60 mg/kg), and TID+Sp rat were pretreated with spermine (Sp, 5 mg/(kg·d)) for 2 weeks before STZ injection. After 12 weeks of modeling, blood glucose, insulin levels, ejection fraction (EF) and shortening fraction (FS) were measured, and Masson staining and Sirius red staining were performed in the rat cardiac tissues. ②Cell experiments: primary CFs were extracted from newborn (1-3 d) Wistar rat hearts, and were randomly divided into control group, high-glucose group (HG) and HG+Sp group (n=6 per group). HG group was treated with 40 mmol/L glucose, and the HG+Sp group was pretreated with 5 μmol/L Sp for 30 min before HG treatment. The cell viability of CFs was detected by CCK8, the content of collagen in culture medium was analyzed by ELISA, and protein expressions of cell cycle related proteins (PCNA, CyclinD1 and P27) were detected by Western blot. Compared with control group, the blood glucose and collagen content were increased, and the insulin level and heart function were decreased in the T1D group. Meanwhile, HG induced an increasing of the cell viability, the collagen content in the medium and the expressions of PCNA and CyclinD1, while the expression of P27 was down-regulated. Spermine could reduce the above changes, manifested as improving the cardiac function, regulating the expression of cyclin and reducing the level of myocardial fibrosis. Spermine can alleviate myocardial fibrosis in diabetic cardiomyopathy, which mechanism is related to the regulation of cell cycle.

Effect of exogenous spermine pretreatment on alleviating renal fibrosis in diabetic nephropathy mice and its related mechanism / 中国应用生理学杂志

To observe the protective effects of exogenous spermine on renal fibrosis induced by diabetic nephropathy (DN) and to explore its mechanism. Twenty-four male C57 mice were randomly divided into control group, type 1 diabetes group (TID) and spermine pretreatment group (TID+Sp, n=8 in each group). TID mice were induced by STZ (60 mg/kg), and TID+Sp mice were pretreated with spermine (5 mg/(kg·d)) for 2 weeks before STZ injection. The mice were killed at the 12th week. The renal function was determined by serum creatinine and urea nitrogen. HE, PAS and Masson staining were used to evaluate renal tissue injury and fibrosis. The expressions of matrix metalloproteinase (MMP-2, MMP-9) and collagen IV (Coll-IV) in the kidney of mice were detected by Western blot. Compared with the control group, the blood glucose (5.67±0.22 vs 28.40±0.57 mmol/L), creatinine (14.33±1.22 vs 30.67±4.73 μmol/L) and urea nitrogen (6.93±4.94 vs 22.00±1.04 mmol/L) in the T1D group were increased significantly (P＜0.05), the glomerular basement membrane was thickened, the collagen was significantly increased, the expressions of MMP-2, MMP-9 and Coll-IV protein were increased (0.57±0.07 vs 1.06±0.20, 47.00±0.04 vs 1.29±0.09 and 0.42±0.16 vs 0.95±0.18,P＜0.05). Exogenous spermine significantly alleviates the above-mentioned changes. Exogenous spermine pretreatment could significantly alleviate renal fibrosis in diabetic mice by regulating the balance between MMPs and collagen.

Effects of interleukin-21 ,interleukin-23 and interleukin-4 on the pathogenesis of Guillain-Barré syndrome and the influence of intravenous immunoglobulin / 中华实用儿科临床杂志

Objective To investigate the effects of IL-21,IL-23 and IL-4 in the pathogenesis of Guillain-Barré syndrome(GBS) of children,and to analyze the influence of intravenous immunoglobulin(IVIG) on the serum levels of IL-21,IL-23 and IL-4 in GBS patients.Methods Forty-one pediatric patients with GBS hospitalized in our department from Jan.2005 to Sep.2012 were studied.According to the time of IVIG administration,patients were divided into group A and group B,given IVIG respectively within the 7th day and the 8th-12th day.According to Hughes score,patients were divided into mild group and severe group.The serum levels of IL-21,IL-23 and IL-4 were detected by means of ELISA before and after treatment.Results Before treatment,the serum levels of IL-21,IL-23 and IL-4 had no signifiant difference between group A and group B.After treatment,the serum levels of IL-21,IL-23 in group A and group B were significantly decreased than those before treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.There was no signifiant difference in group A and group B in the serum levels of IL-21,IL-23 and IL-4 after treatment (all P ＞0.05).In the severe group,the serum levels of IL-21,IL-23 were significantly higher than those in the mild group before and after treatment (all P ＜ 0.05),with no significant difference in IL-4 levels.After treatment,the serum levels of IL-21,IL-23 were significantly decreased than those before treatment in the mild group and the severe group (all P ＜ 0.05),with no significant difference in IL-4 levels.Conclusions The serum levels of IL-21,IL-23 are significantly increased in GBS children,indicating they play an important role in the pathogenesis of GBS.Levels of IL-21 and IL-23 are significantly decreased after administration of IVIG,which showed that IVIG could inhibit the secretion of IL21 and IL-23,reduce cellular inflammatory response,and eventually prevent the development of GBS.IL-4 secretion is not obviously affected with IVIG,it might have a role in the recovery of GBS.

A study of approaches in reimplantation of avulsed brachial plexus ventral roots into the spinal cord / 中华创伤骨科杂志

Objective To study the microsurgical and anatomic structures of brachial plexus roots and vertebral canal to find the best approaches for reimplantation of avulsed brachial plexus ventral roots into the spinal cord.Methods On nineteen cervicothoracic spine specimens,the brachial plexus nerves were exposed along to intervertebral foramen,and the spinal cord and brachial plexus roots were exposed by excising the vertebral arch and sectioning the spinal dura mater.The anatomy of brachial plexus roots and vertebrae,and the relative positions of spinal cord segments to vertebral discs were measured and observed.Results The relative positions of spinal cord segments to vertebral discs are:C5-7 spinal cord segments face C3,4,C4,5 and C5,6 vertebral discs;and C8 and T1 spinal cord segments face C6 and C7 vertebrae.Based on the anatomic finding,four approaches were found out: the lateroventral approach,the lateral approach by enlarging intervertebral foramen,the laterodorsal approach and the lateral and dorsal combined approach.Conclusions The brachial plexus ventral roots can be best reimplanted into the spinal cord by the lateroventral approach and the lateral approach.Although the laterodorsal approach and the lateral and dorsal combined approach are not the best,they are less difficuh and dangerous.