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Objective:To assess the efficacy and the safety of the radiofrequency catheter ablation (RFCA) for the septal accessory pathway (AP) in children.Methods:From September 2013 to March 2019, 626 patients plan to underwent RFCA for paroxysmal supraventricular tachycardia (PSVT) in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine.Among them, 74 consecutive patients with right or left septal APs were included in the study and their clinical and RFCA data were analyzed.Results:The age of these 74 children (45 males, 29 female) was (7.8±3.5) years, ranging from 10 months to 13 years.The body weight (BW) was (27.7±14.4) kg, with 3 patients BW<15 kg.A discordant ventricular wall motion (DVWM) was found in 5 patients, and the combined congenital heart diseases were discovered in 2 patients.A three dimensional mapping system was applied in 69 ablations, and 3 ablations were performed only with the fluoroscopy monitor of 5 cases.According to the AP location, the number of cases located in the anteroseptal, the midseptal, the mouth of coronary sinus, the left posteroseptal and the right posteroseptal, were 28, 18, 10, 10 and 8, respectively.The ablation operations were applied in 72 patients.The initial acute success reached in 67 (93.1%) patients.The ablation energy was (18.0±1.8) W, the fluoroscopy time during the ablations was (4.7±2.7) minutes, and the procedure duration was (151.5±58.6) minutes.One inadvertent complete atrioventricular block (AVB) was noted as the ablation-related complication.All 5 children with the pre-DVWM were recovered after ablations.During a follow-up of (23.8±10.8) months, 4 patients experienced the recurrence of preexcitation syndrome atrioventricular reentrant tachycardia.Conclusions:With the 3D-mapping system, the RFCA of septal APs can be performed safely and effectively in pediatric patients of paroxysmal supraventri-cular tachycardia.However, as the ablation-related complication, AVB should not be ignored.
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OBJECTIVE@#To explore the genetic basis for 7 patients with Alström syndrome.@*METHODS@#DNA was extracted from peripheral blood samples of the patients and their parents. Whole exome sequencing was carried out for the patients. Suspected variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#Genetic testing revealed 12 variants of the ALMS1 gene among the 7 patients, including 7 nonsense and 5 frameshift variants, which included c.5418delC (p.Tyr1807Thrfs*23), c.10549C>T (p.Gln3517*), c.9145dupC (p.Thr3049Asnfs*12), c.10819C>T (p.Arg3607*), c.5701_5704delGAGA (p.Glu1901Argfs*18), c.9154_9155delCT (p.Cys3053Serfs*9), c.9460delG (p.Val3154*), c.9379C>T (p.Gln3127*), c.12115C>T (p.Gln4039*), c.1468dupA (p.Thr490Asnfs*15), c.10825C>T (p.Arg3609*) and c.3902C>A (p.Ser1301*). Among these, c.9154_ 9155delCT, c.9460delG, c.9379C>T, and c.1468dupA were unreported previously. Based on the standards and guidelines of American College of Medical Genetics and Genomics, the c.9379C>T and c.12115C>T variants of the ALMS1 gene were predicted to be likely pathogenic (PVS1+PM2), whilst the other 10 variants were predicted to be pathogenic (PVS1+ PM2+ PP3+PP4).@*CONCLUSION@#ALMS1 variants probably underlay the Alström syndrome in the 7 patients, and genetic testing can provide a basis for the clinical diagnosis of this syndrome. The discovery of four novel variants has expanded the mutational spectrum of Alström syndrome.
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Humanos , Síndrome de Alstrom/genética , Proteínas de Ciclo Celular/genética , Mutación , Linaje , Secuenciación del ExomaRESUMEN
Objective To describe the clinical characteristics,treatment and outcomes of Staphylococcus aureus infective endocarditis (SAIE) in children.Methods One hundred and fifty-one children with infective endocarditis (IE) and treated in Shanghai Children's Medical Center of Shanghai Jiaotong University School of Medicine were retrospectively analyzed,from January 2007 to December 2017.There were 88 boys and 63 girls,the age of IE onset ranged from 1 month to 17 years [(6.27 ±4.80) years].There were 23 cases (15.2％) with infection of staphylococcus aureus,128 cases with non-Staphylococcus aureus infective endocarditis (NSAIE).The clinical characteristics,treatment and prognosis of patients between the SAIE group and the NSAIE group were analyzed and compared.Results Among the SAIE group,there were 15 boys and 8 girls,the age of IE onset ranged from 3 months to 16 years [(6.2 ±5.6) years];10 cases of them had no underlying heart disease.There was no significant difference in gender,age and previous cardiac surgery between the SAIE group and the NSAIE group (all P ＞ 0.05).The number of patients without underlying heart disease in the SAIE group was more than that in the NSAIE group,and the difference was statistically significant [43.5 ％ (10/23 cases) vs.20.3 ％ (26/128 cases),x2 =5.762,P =0.016].Compared with the NSAIE group,the SAIE group was associated with significantly higher levels of C-reactive protein [60.0 (128.0) mg/L vs.25.0(58.0) mg/L,Z =-2.033,P =0.042],higher erythrocyte sedimentation rate [(59.3 ±43.2) mm/h vs.(39.4 ±31.5) mm/h,t =-2.283,P =0.024],and lower levels of serum albumin [30.1 (12.7) g/L vs.34.3 (8.4) g/L,Z =-2.282,P =0.022].The proportion of severe sepsis in the SAIE group was also significantly higher than that in the NSAIE group [21.7％ (5/23 cases) vs.7.0％ (9/128 cases),Z =5.014,P =0.045].Twelve cases (52.2％) of the SAIE group had systemic embolic events,including cerebral events (6 cases),pulmonary (2 cases),limbs (1 case),splenic (1 case),limbs and mesenteric (1 case),limbs and cerebral events (1 case).Eighteen cases in the SAIE group were treated with antibiotics combined with surgery and l case died,while 5 cases were treated with antibiotics alone,4 cases died and 1 case abandoned.The SAIE patients had a significantly higher systemic embolic rate [52.2％ (12/23 cases) vs.20.3％ (26/128 cases),x2 =7.978,P =0.016],neurological events rate [30.4％ (7/23 cases) vs.10.9％ (14/128 cases),x2 =4.669,P =0.031] and in-hospital mortality [21.7％ (5/23 cases) vs.6.3％ (8/128 cases),x2 =4.139,P =0.042] than those in the NSAIE group.Conclusions SAIE was most common in those without heart disease.Compared with NSAIE,SAIE is characterized by a higher prevalence of severe sepsis,major neurological events,and inpatient mortality.Timely surgery is recommended in these cases,when possible,before the occurrence of complications.
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Objective@#To describe the clinical characteristics, treatment and outcomes of Staphylococcus aureus infective endocarditis (SAIE) in children.@*Methods@#One hundred and fifty-one children with infective endocarditis (IE) and treated in Shanghai Children′s Medical Center of Shanghai Jiaotong University School of Medicine were retrospectively analyzed, from January 2007 to December 2017.There were 88 boys and 63 girls, the age of IE onset ranged from 1 month to 17 years [(6.27±4.80) years]. There were 23 cases (15.2%) with infection of staphyloco-ccus aureus, 128 cases with non-Staphylococcus aureus infective endocarditis (NSAIE). The clinical characteristics, treatment and prognosis of patients between the SAIE group and the NSAIE group were analyzed and compared.@*Results@#Among the SAIE group, there were 15 boys and 8 girls, the age of IE onset ranged from 3 months to 16 years [(6.2±5.6) years]; 10 cases of them had no underlying heart disease.There was no significant difference in gender, age and previous cardiac surgery between the SAIE group and the NSAIE group (all P>0.05). The number of patients without underlying heart disease in the SAIE group was more than that in the NSAIE group, and the difference was statistically significant[43.5%(10/23 cases) vs.20.3%(26/128 cases), χ2=5.762, P=0.016]. Compared with the NSAIE group, the SAIE group was associated with significantly higher levels of C-reactive protein [60.0(128.0) mg/L vs.25.0(58.0) mg/L, Z=-2.033, P=0.042], higher erythrocyte sedimentation rate [(59.3±43.2) mm/h vs.(39.4±31.5) mm/h, t=-2.283, P=0.024], and lower levels of serum albumin [30.1(12.7) g/L vs.34.3(8.4) g/L, Z=-2.282, P=0.022]. The proportion of severe sepsis in the SAIE group was also significantly higher than that in the NSAIE group [21.7%(5/23 cases) vs.7.0%(9/128 cases), Z=5.014, P=0.045]. Twelve cases (52.2%) of the SAIE group had systemic embolic events, including cerebral events (6 cases), pulmonary (2 cases), limbs (1 case), splenic (1 case), limbs and mesenteric (1 case), limbs and cerebral events (1 case). Eighteen cases in the SAIE group were treated with antibiotics combined with surgery and 1 case died, while 5 cases were treated with antibiotics alone, 4 cases died and 1 case abandoned.The SAIE patients had a significantly higher systemic embolic rate [52.2%(12/23 cases) vs.20.3%(26/128 cases), χ2=7.978, P=0.016], neurological events rate [30.4%(7/23 cases) vs.10.9%(14/128 cases), χ2=4.669, P=0.031] and in-hospital mortality [21.7%(5/23 cases) vs.6.3%(8/128 cases), χ2=4.139, P=0.042] than those in the NSAIE group.@*Conclusions@#SAIE was most common in those without heart disease.Compared with NSAIE, SAIE is characterized by a higher prevalence of severe sepsis, major neurological events, and inpatient mortality.Timely surgery is recommended in these cases, when possible, before the occurrence of complications.
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Objective@#To evaluate the clinical effect and summarize the experience of radiofrequency catheter ablation (RFCA) for children suffered from premature ventricular contractions (PVCs).@*Methods@#This retrospective study was conducted by descriptive analysis. A total of 108 cases with frequent PVCs from Shanghai Children's Medical Center were treated with RFCA under the guidance of CARTO3 system from January 2011 to December 2016. The immediate success rate of the procedure, the recurrence rate and the perioperative complications were summarized. The constituent ratio of different PVCs origins, the trend of overall procedure time and success rate in recent years were analyzed. Statistical analyses were performed using F test.@*Results@#Immediate success of RFCA was achieved in 104 cases (96.3%, 104/108) and 4 cases (3.7%, 4/108) failed. The PVCs recurred during follow-up of over 6 months in 5 cases (4.8%, 5/104) . There were no severe complications related to the procedure. The sites of PVCs origin, in 52 cases originated from right ventricular outflow track (48.2%, 52/108) , 17 cases originated from left ventricular outflow track (15.7%, 17/108) and 26 cases originated from tricuspid annulus (24.1%, 26/108) . Among the three predilection sites of PVCs, the operation time was (141±46) min for right ventricular outflow track, (155±50) min for left ventricular outflow track, and (166±57) min for tricuspid annulus. However, the difference was not statistically significant (F=1.79, P=0.17) . X-ray exposure time was (14±8) minutes for right ventricular outflow track ablation, (32±14) minutes for left ventricular outflow track ablation and (16±8) minutes for tricuspid annulus ablation respectively. The exposure time for the ablation on left ventricle was significantly longer than the other two sites (F=5.12, P=0.018) .@*Conclusion@#RFCA is safe and effective for PVCs in children with high success rate and low recurrence and complication rates.
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Objective@#To analyze characteristics of permanent pacemaker implantation in children as well as treatment and prognosis of complications.@*Method@#Clinical data of children who underwent endocardial or epicardial permanent pacemaker implantation between April 2000 and June 2016 in Shanghai Xinhua Hospital and Shanghai Children′s Medical Center were analyzed retrospectively. These patients were discharged 5 days after implantation. Electrocardiogram, chest X ray, echocardiography and pacemaker programming were performed during follow-up. Treatment regimes, complication management and prognosis were analyzed retrospectively.@*Result@#Data of a total of 193 cases were collected. One hundred and six patients were male and 87 patients were female.The average age was (5.09±4.05) years(0.4-16 years)and the average weight was (20.47±11.62) kg.133(68.9%); patients were implanted with endocardial pacemakers and 60(31.1%)patients were implanted with epicardial pacemakers; 135(69.9%)patients were single-chamber paced with 87 from RVA and 48 from RVOT. fifty-eight(30.1%)patients were dual chamber paced. These included 122(63.2%)postoperative third degree AV block(Ⅲ-AVB), 38 (19.7%)congenital complete AV block (CCAVB), 3(1.6%)post ventricular septal defect (VSD) interventional therapy AV block, 23 (11.9%)sick sinus syndrome (SSS) and 7(3.6%)Ⅲ-AVB after fulminant myocarditis. One hundred and thirty-seven(71%)patients were followed up for an average duration of 5.32 years(0.3-10 years). Pacemaker exchange were performed in 46 patients due to battery exhaustion.The average life of battery was 5.4 years (1-9 years). Sixteen patients underwent lead exchange due to dislocation or separation.One patient underwent lead extraction due to recovery of AV conduction 21 days after surgery for complete transposition of great arteries (D-TGA/VSD). Skin abrasion, infection or dehiscence occured in 6 patients. Heart failure occurred in 2 patients at 6 and 8 years after implantation whose heart functions improved after switching from VVI to DDD or adding ACEI . One patient died suddenly due to ineffective pacing caused by lead fracture. Another patient under DDD pacing was found to have atrial myocardial perforation with normal sensing and pacing so that no intervention was performed.@*Conclusion@#The pacing mode and path through which leads are implanted for permanent pacemaker implantation in children have their peculiar characteristics.Some complications might occur during follow-up with good prognosis if appropriately treated.
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Objective To investigate the influencing conditions of human epidermal stem cells(ESCs) differentiating into gland-like cells and to identify the induced tubular structure.Methods The ESCs were seeded onto compound polysaccharide shell dermal matrix and collagen gel,adding different concentrations of epidermal growth factor(EGF) and culturing by vertical shaking in vitro,the three dimensional culture and induced directional differentiation were performed.The means of HE staining,immunofluorescence and confocal laser scanning microscope were adopted to observe the conditions,morphology and phenotype change of ESCs directionally differentiating into glandular epithelium-like cells.Results 15-20 ng/mL EGF could induce ESCs in tissue-engineering dermis to grow into dermis and appear the gland-like structure.The HE staining in this structure showed its profile as a single layer with lacune in the middle compartment,eosinophilic cytoplasm,lightly stained.Under CLSM,by CK19 staining,the luminal structure in the middle of the cell mass was observed,while CK18 and CEA were expressed in this structure.Conclusion Under the induction of particular concentration of EGF,the in vitro cultured human ESCs seeded on the tissues engineering dermis could form into the tubular structure,which is similar to the in vivo sweat gland secretory cells in morphology and histology.
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Premature ventricular complex (PVC)-induced cardiomyopathy is due to frequent PVCs and it can be potentially reversible in selected patients resolves after catheter ablation.PVCs burden is importantly associated with impaired left ventricular(LV) function.Necessary evaluation is important for PVCs patients.For patients with high PVC burdens above 15％-25％ of the total cardiac beats in 24 hours,medical treatment should be used to reduce PVC burden and to improve LV function.Catheter ablation of PVCs is recommended for selected patients with high PVC burdens associated with a decline in LV systolic function.
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The training of professional postgraduates is one mode of medical postgraduate training,which more emphasizes the cultivation of clinical practice and ability.The problems existing in the training of professional degree postgraduates in dermatology are analyzed in this article,such as weak foundation of scientific research foundation,lack of supervision and evaluation,and the challenges from dermatology characteristics.The solutions including the training objectives,project design,the optimization of teaching process and evaluation,the training of comprehensive ability will be discussed in this article.The purpose is to improve the quality of training,to give some advice for providing high quality professional degree postgraduates.
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Objective To explore the effectiveness and safety of Linezolid (LIZ) in treating children with infective endocarditis (IE).Methods The clinical data of 112 children with IE and treated in the Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine from August 2008 to September 2015 were retrospectively analyzed.There were 64 boys and 48 girls,and the age of IE onset ranged from 1 month to 17 years [(6.0 ± 4.8) years].Twenty-nine patients received LIZ treatment ＞ 7 days (LIZ treatment group),including 21 males and 8 females,and the age ranged from 5 months to 15 years [(6.9 ±5.2) years].The remaining 83 patients were identified without LIZ treatment(non-LIZ treatment group),including 43 boys and 40 girls,and the age ranged from 1 month to 17 years [(5.7 ±4.7) years].The etiological results,curative effect and adverse reactions of the LIZ treatment group were observed.Results Among the LIZ treatment group,22 cases had congenital heart disease and 1 case had intravenous catheter.There were 10 cases with infection of staphylococcus aureus,6 cases with coagulase negative staphylococcus,5 cases with oral streptococci and Streptococcus bovis group,3 cases with streptococcus pneumonia,2 cases with enterococcus faecium and 3 cases with negative blood culture results.All cases of the LIZ treatment group received Vancomycin therapy at first,LIZ was given when the Vancomycin therapy failed(16 cases with temperature reiteration,1 case inadequate microbiological response),Vancomycin intolerance (6 neutropenia,2 renal toxicity,2 allergy),and oral maintenance therapy (2 cases).The duration of LIZ treatment ranged from 9 to 135 days [(39.2 ±27.2) days].Three patients (10.3％) had adverse effects during LIZ treatment,1 case with severe digestive symptoms after treatment,1 case with teeth discoloration,1 case with the indicators decreasing by 2 routine blood test.Meanwhile,16 cases of 85 patients (18.8％) had side effects during Vancomycin treatment,in which 7 cases with neutropenia,6 cases with rash and 3 cases with renal insufficiency.But there were no significant differences in adverse effects between LIZ and Vancomycin treatment (x2 =1.l19,P ＞0.05).Twenty-five cases were cured (86.2％) and 2 cases dead (6.9％) in the LIZ treatment group.And no significant difference was found in cure rate,or mortality between LIZ treatment group and non-LIZ treatment group (86.2％ vs.77.1％,x2 =1.090;6.9％ vs.8.4％,x2 =0.069,all P ＞ 0.05) at 6 to 84 (23.9 ± 19.1) months follow-ups.Conclusions LIZ can be used to deal with Vancomycin failure and IE caused by gram positive coccus.LIZ was generally well tolerated in patients with IE.It may be useful in cases of IE complicated by brain abscesses for the good distribution.It is 100％ orally bioavailable,allowing oral administration for outpatients.
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Objective To compare the epidermal shape built by different passages of keratinocytes and its ability of proliferation and differentiation in three-dimensional conditions.Methods Different passages of keratinocytes were used to construct tissue-engineered skin.The morphology of the tissue-engineered skin was observed with HE and PAS staining,while CK1/CK10,CK5/CK14,Ki67 were detected by immunohistochemical assays.Results All the tissue-engineered skin had a significant dermoepidermal structure.The stratification of 1st and 2nd passage skins were better,and 2nd passage epidermis was thicker than that in other passages (P＜0.05).Dermoepidermal structure in collagen type Ⅳ group binded more tightly,but collagen type Ⅳ had little effect on the thickness of the epidermis (P＞0.05).In collagen type Ⅳ group PAS stain was negative,indicating type Ⅳ collagen was unable to promote the reconstruction of BM in vitro.The Ki-67 proliferation index of the 2nd keratinocyte was similar to the normal skin,the remaining passages keratinocyte proliferation gradually decreased (P＜0.05) ; the 1st and 2nd passage skins expressed CK1/CK10 and CK5/CK14.Conclusions Keratinocytes before the 3rd passage have a better ability in the proliferation and differentiation,and so they are more suitable as seed cells for tissue-engineered skin.
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Objective To establish the three-dimensional culture model of the human skin squamous-celled carcinoma ,and isolate the highly invasive cell subsets ,and compare their biological characteristics .Methods By using the composite chitosan tissue engi-neering skin ,the three-dimensional culture model of the human skin squamous-celled carcinoma was successfully established , through digestion ,we divided and got the high-invasive squamous carcinoma cells subsets .After that ,the different invasive proper-ties of subpopulations of cells in nude mice tumor effects were compared .Results Different concentrations of cinnamaldehyde and interferon on skin squamous-celled carcinoma cell proliferation inhibition had statistical significance (P<0 .01) ,the different invasive characteristics of skin squamous cells carcinoma between subpopulations of cells proliferation inhibition also was statistically signifi-cant(P<0 .01) ,and the two different invasive properties of subpopulations of cells in the tumor characteristics also had statistical significance(P<0 .01) .Conclusion We established the three-dimensional culture model of the human skin squamous-celled carcino-ma successfully ,by using this model ,we could screen the higher invasive cells subsets .
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Dermatology and venerology is a clinical discipline characterized by morphology.With the development of the internet and the application of internet in education,the features and advantages of internet teaching are gradually recognized including high flexibility,rich information and good student-teacher interaction.This article focused on the establishment and practice of internet teaching to improve teaching quality.
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Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome, characterized by the association of facial port-wine hemangiomas in the trigeminal nerve distribution area, with vascular malformation(s) of the brain (leptomeningeal angioma) with or without glaucoma. Herein, we reported Sturge-Weber syndrome in a 50-year-old man, who presented port-wine hemangiomas and epilepsy. In this case, the patient's epilepsy episodes from his first year of life had been ignored and separated from the entity of SWS by his physicians, which led to delayed treatment. This case illustrates the importance of careful examination of patients of any age with hemangiomas in the trigeminal nerve with concomitant episodes of epilepsy. In such cases, there should be yearly neuroimaging screenings to guaranteed early interdisciplinary interventions from the time of definite diagnosis.
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Humanos , Persona de Mediana Edad , Encéfalo , Epilepsia , Glaucoma , Hemangioma , Tamizaje Masivo , Síndromes Neurocutáneos , Neuroimagen , Síndrome de Sturge-Weber , Nervio TrigéminoRESUMEN
Bilingual teaching is very important to the development of medical education and integration with the advance medicine knowledge in the world.Rich teaching experiences have been summarized during these years.This article summarizes the bilingual teaching experience from four parts including the concept of bilingual education,conditions of bilingual education,methods of bilingual education,results of bilingual education.We have also found some problems during teaching and worked out the improvement methods.
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Objective To investigate the effect of hepatocyte growth factor (HGF) on migration and apoptosis of,as well as phosphorylated-Akt (p-Akt) expression in cultured human eccrine sweat gland epithehal cells (hESGc).Methods The first generation of hESGc were cultured in keratinocyte serum free medium (KSFM) and treated with various concentrations (2,20,40μg/L) of HGF for different durations.Then,cell scratch test was performed to detect cell migration,a double staining flow cytometry assay using annexin VFITC/propidium iodide to detect cell apoptosis.and Western blot to measure the expression of p-Akt.Results HGF of 2μg/L had no effect on the migration of hESGc,while that of 20 μg/L and 40μg/L could promote the migration of hESGc by 33.2% and 228.2%.respectively.The average number of cells migrating into the scrach zone was significantly lower in untreated cell group than that in 20 and 40μg/L HGF-treated cell group (17.3±5.5 vs 23.0±6.3 and 56.7±7.9,t=2.653, 15.858,P<0.05,0.01, respectively).The apoptosis rate was 14.76% in untreated cells,14.16%,13.5% and 8.87% in cells treated with HGF of 2,20 and 40μ/L, respectively;there was a significant difference between untreated cells and 40μg/L HGF-treated cells (t=7.852,P<0.01).HGF could activate the phosphorylation of Akt protein and increase the expression of p-Akt.Conclusion HGF could promote the migration of,inhibit the apoptosis of,and stimulate the p-Akt expression in.hESGc.
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<p><b>OBJECTIVE</b>To evaluate the feasibility of developing brain-targeted nasal delivery system of scutellarin by the passage between nase and brain in nasal olfactory area.</p><p><b>METHOD</b>The samples of cerebrospinal fluid (CSF) and blood were prepared by cranial puncture and femoral artery catheterization methods respectively according to the certain sampling time after drug administered. The scuteIlarin concentration of samples were determined by 125 marked method. Pharmacokinetic parameters were calculated by trapezoidal rule. The brain-targeted trendence were evaluated by the value of the index AUC(brain)/AUC(plasma).</p><p><b>RESULT</b>The distribution of scutellarin in brain following intranasal administration was different between tissues. Drug concentration in olfactory bulb achieved to peak at 5-15 min after intranasal administration, while in brain tissue was 30-60 min. Above all, peak concentration in olfactory bulb and olfactory region respectively were (574.8 +/- 205.), (323.4 +/- 128.3) ng x g(-10, both are higher than CSF, which is (123.2 +/- 29.3) ng x g(-1). Moreover, the distribution of scutellarin given by intranasally in brain was: olfactory bulb (OB) > olfactory region (OR) > cerebrospinal fluid (CSF) > cerebellum(CB) > medulla oblongata (MO) > cerebrum (CR); AUC(0-240) of olfactory bulb, olfactory region and CSF after scutellarin intranasal administration were 5.54, 5.07 and 5.51 times of that after intravenous injection, respectively. And the AUC(0-240) of other brain tissues after intranasal administration were also higher than that after intravenous injection. AUC(brain tissue)/ AUC(plasma) of every brain tissues by intranasally are all higher than that by intravenously remarkably. For instance, 5 min after intranasal administration, the value of AUC(CSF)/ AUC(plasma), AUC(OB)/AUC(plasma), and AUC(CR)/AUC(plasma) were 30.34, 56.93, and 6.14 times of that by intravenously.</p><p><b>CONCLUSION</b>Part of scutellarin could be straightly transported into brain by the intranasal administration. Its absorption pathway was: the molecule of Scutellarin throughed olfactory mucosa in nasal cavity into olfactory bulb in arachno-hypostegal cavity, and then entered into olfactory region, CSF, cerebrum and cerebellum gradually. It showed that olfactory bulb was the only way for drug molecule to go through nasal cavity into brain. It had a significant trendence of brain-targeted when compared to oral administration and intravenous injection, which indicated a certain feasibility to develop a brain-targeted nasal delivery system for scutellarin.</p>
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Animales , Masculino , Ratas , Administración Intranasal , Apigenina , Farmacocinética , Encéfalo , Metabolismo , Sistemas de Liberación de Medicamentos , Métodos , Glucuronatos , Farmacocinética , Ratas Sprague-DawleyRESUMEN
Objective To investigate the influence of Wnt-3a signaling on aggregative growth of dermal papilla cells.Methods Recombinant adenovirus pAdEasy-1/Wnt-3a was constructed at first,and used to transfect cultured dermal papilla cells(DPCs).Then,the growth pattem of DPCs was observed by inverse microscopy;laser confocal microscopy and Western blot were utilized to detect the expressions of Wnt-3a,β-catenin and versican in low-passage DPCs,high-passage DPCs and transfected high-passage DPCs.Results The over-expression of Wnt-3a protein could effectively induce the aggregative growth of DPCs.Laser confocal microscopy showed that the fluorescence intensity of β-catenin and versican increased from 34.16±9.62 and 18.81±9.59 in high-passage DPCs to 87.35±17.28 and 92.18±18.39 in transfected high-passage DPCs(t=11.98,17.88,both P＜0.0 1),respectively.Also,Western blot proved a significant increase of expression intensity of β-catenin(15.27±2.17 vs 60.09±7.24,t=10.10,P＜0.01)and versican(19.32±2.46 vs 58.46±2.78,t=20.63,P＜0.01)in transfected high-passage DPCs compared with untransfected high-passage DPCS.ConclusionsWnt-3a signaling plays an important role in modulating aggregative growth of DPCs,which is mainly through the classical pathway with β-catenin as the key protein.As an important downstream gene of Wnt signaling,vesican is an indispensable part for the modulation of aggregative growth of DPCs.
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Objective:To study the effect of seeding cells of tissue-engineered skins,keratinocytes and fibroblasts,on the phenotypes of langerhans cells (LC).Methods:Peripheral blood mononuclear cells were induced by cytokines,granulocyte macrophage-colony stimulating factor (GM-CSF),interleukin 4 (IL-4),transforming growth factor β1 (TGF-β1) to generate LCs,which were subsequently cocultured with allogenic keratinocytes or fibroblasts.Then the phenotypes of langerhans cells was detected by flow cytometer (FCM),and the degree of proliferation of autogeneic lymphocytes was assessed after stimulation with LCs.Results:Cultured LCs had low level expression of HLA-DR,CD80,CD86 and no expression of CD83.Cocultured with allogenic keratinocytes or fibroblasts,phenotypes of LCs did not change significantly.Simultaneously,LCs could not stimulate autogeneic lymphocytes proliferation.Conclusion:These data indicate that LCs cocultured with seeding cells of tissue-engineered skins remain immature state.It is suggested that seeding cells of tissue-engineered skins have low immunogenicity and are unable to induce significant immunological rejection of host after transplantation.
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Objective To investigate the clinical outcomes of surgical excision combined with recom binant interferon aipha-2b in the treatment of acral malignant melanoma (MM). Methods Fifteen patients with acral MM admitted to the department since 2004 were recruited into this study. The tumors varied from 1.8 mm to 3.9 mm in invasion depth. Thin tumors with an invasion depth of 1.8 - 2.0 mm were excised with a margin of lcm beyond the tumors, and those with an invasion depth of 2.0 - 3.9 mm were excised with a margin of 2 cm beyond the tumors. After excision, 4 cases of minor excision were sutured directly, 10 cases of large excision were repaired with adjacent skin grafts and flaps, 1 patient with the involvement of the first metatarsophalangeal joint underwent toe amputation followed by the repair of planta wound surface with the remaining skin on the dorsa of toes. Patients received intramuscular recombinant interferon alpha-2b for 3 months (3 million units daily for the first 3 days and 6 million units for the remaining days) following operation. Results There were 6 cases of MM in situ and 9 cases of invasive MM in this study. All the skin grafts and flaps survived. Within the 3-year follow up, relapse was observed only in 1 patient with invasive MM. Recovery was achieved in the functions of feet in all patients. Conclusion The excision of tumors with a margin determined by tumor thickness plus intramuscular interferon alpha-2h may improve the survival of patients with cutaneous MM in planta pedis with avoidance of amputation.