LY294002 blocks the effect of dexamethasone in reducing urine protein in rats by inhibiting PI3K/Akt signaling pathway / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the involvement of PI3K/Akt signaling pathway in the changes of urine protein in adriamycin-induced nephropathic rats treated with dexamethasone and LY294002 (a PI3K inhibitor).</p><p><b>METHODS</b>SD rats were randomized into normal control group, ariamycin-induced nephropathy group (ADR group), ariamycin+dexamethasone group (DEX group), and ADR+DEX+LY294002 group (LY294002 group). On days 7, 14 and 28 after the treatments, 24-h urine was collected from the rats to analyze the total urine proteins. The renal tissues were obtained on day 28 to examine the expressions of p-AKT, AKT and Bad proteins in the cortical tissues using Western blotting; the expression of Bad mRNA in the cortical tissues was measured by QPCR.</p><p><b>RESULTS</b>Urine protein increased progressively in ADR group accompanied by significantly reduced p-AKT/AKT ratio and increased Bad mRNA expression in comparison with those in the normal control group (P<0.05). Urine protein was obviously reduced in DEX group with comparable p-AKT/AKT ratio and Bad mRNA expression level with those in the control group (P>0.05). Urine protein showed no significant reduction in LY294002 group, but the p-AKT/AKT ratio was significantly reduced and Bad mRNA expression was increased compared with those in DEX group (P<0.05).</p><p><b>CONCLUSION</b>Dexamethasone increases the expression of Bad mRNA and reduces urine protein in adriamycin-induced nephropathic rats by activating PI3K/Akt signaling pathway. LY294002 can inhibit PI3K/Akt signaling pathway to block the effect of dexamethasone, suggesting that PI3K/Akt signaling pathway is one of the signaling pathways that mediate the effect of dexamethasone on proteinuria.</p>

Renal artery injury caused by Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate renal artery injury caused by Kawasaki disease (KD).</p><p><b>METHODS</b>Forty-three children with KD were enrolled in the study. According to the blood pressure in the acute stage, these children were classified into normal blood pressure subgroup and increased blood pressure subgroup. Eighteen children with fever caused by acute upper respiratory tract infection were enrolled as the control group. The diameter of the origin of the main renal artery, hemodynamic parameters of the main renal artery and the renal interlobar artery, rennin activity, and levels of angiotensin II and aldosterone were compared between groups.</p><p><b>RESULTS</b>During the acute stage of KD, both subgroups had a significantly smaller diameter of the origin of the main renal artery, a significantly higher resistance index (RI) of the main renal artery, and a significantly lower end-diastolic velocity (EDV) than the control group (P<0.05).The increased blood pressure subgroup had a significantly lower EDV of the interlobar artery than the normal blood pressure subgroup, a significantly higher RI than the normal blood pressure subgroup and the control group, as well as a significantly higher rennin activity and significantly higher levels of angiotensin II and aldosterone than the normal blood pressure subgroup (P<0.05). A significantly increased EDV and a significantly reduced RI of the renal interlobar artery were observed in the increased blood pressure subgroup in the subacute stage compared with the acute stage (P<0.05).</p><p><b>CONCLUSIONS</b>KD may cause renal artery injury and early hemodynamic changes, resulting in a transient increase in blood pressure in some patients.</p>

Expression of CysLTR-1 and CysLTR-2 in adenoid tissues from children with adenoid hypertrophy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine the expression of cysteinyl leukotriene receptor-1 (CysLTR-1) and cysteinyl leukotriene receptor-2 (CysLTR-2) in the adenoid tissues from children with adenoid hypertrophy (AH) and to explore the role of leukotrienes in the pathogenesis of AH.</p><p><b>METHODS</b>Sixty children with AH who were treated by adenoidectomy and/or tonsillectomy were classified into two groups: simple AH and AH plus allergic rhinitis (n=30 each). Twenty children who underwent tonsillectomy due to recurrent purulent tonsillitis were selected as the control group. The expression of CysLTR-1 and CysLTR-2 in the excised tonsil and/or adenoid tissues was determined by immunofluorescence histochemical labeling and integrated optical density measurement.</p><p><b>RESULTS</b>The expression of CysLTR-1 and CysLTR-2 in the adenoid and tonsil tissues increased significantly in both the simple AH group and AH plus allergic rhinitis group compared with the control group (P<0.01). The expression of CysLTR-1 and CysLTR-2 in the AH plus allergic rhinitis group increased more significantly compared with the simple AH group (P<0.01).</p><p><b>CONCLUSIONS</b>CysLTR-1 and CysLTR-2 are highly expressed in the adenoid tissues from children with AH, suggesting that leukotrienes are involved in the pathogenesis of AH.</p>

Clinical significance of determination of serum IgE in infants with milk allergy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine the clinical significance of milk protein-specific IgE (sIgE) for infants with cow's milk protein allergy (CMPA).</p><p><b>METHODS</b>Ninety-six infants with CMPA were divided into IgE+ group (n=26) and IgE- group (n=70) and clinical characteristics were compared between the two groups. Infants were denied allergy-inducing food and fed instead extensively hydrolyzed formulas or amino-acid formulas for 16 weeks before the two groups were compared.</p><p><b>RESULTS</b>Twenty-seven percent of the infants were sIgE-seropositive. The first onset age of CMPA was significantly younger in the IgE+ group than in the IgE- group (P<0.05), and the family history of allergy and respiratory symptoms were significantly less common in the IgE- group than in the IgE+ group (P<0.05). Severe CMPA, gastrointestinal symptoms, underweight, growth retardation, anemia, and hypoproteinemia were significantly more common in the IgE- group than in the IgE+ group (P<0.05). Erythema, urticaria, vomiting, nasal discharge, cough, wheezing, and paroxysms of crying were major clinical symptoms of the IgE+ group, and their incidences were significantly higher in the IgE+ group than in the IgE- group (P<0.05); eczema, constipation, and diarrhea were major symptoms of the IgE- group, and their incidences were significantly higher in the IgE- group than in the IgE+ group (P<0.05). The remission rate of each symptom was as high as over 80% in the two groups after 16 weeks of intervention and there was no significant difference in the remission rates between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>IgE seropositive rate is not high in infants with CMPA. Atypical signs instead of allergic symptoms are more common in the IgE seronegative infants with CMPA. Avoiding allergy-inducing food and eating extensively hydrolyzed formulas or amino-acid formulas in early age benefit infants with IgE-mediated or non-IgE-mediated CMPA.</p>

Clinical similarities and differences in Kawasaki disease during 1991-2001 and 2002-2011 periods / 中华实用儿科临床杂志

Objective To analyze the changes in clinical characteristics of Kawasaki disease (KD) between the first and the second decade and improve the diagnosis and treatment of incomplete KD.Methods Retrospective analysis of clinical data of children with KD was performed in the Second Affiliated Hospital of Guangzhou Medical Coliege during the recent 20 years (between Dec.1991 and Dec.2011).The changes in clinical manifestations of KD were compared between the first l0 years and the second l0 years.A total of 270 hospitalized patients diagnosed as KD were included in this study.The patients admitted after Dec.2001 were assigned as the observation group (192 cases) and those admitted before Dec.2001 were assigned as the control group (78 cases).The epidemiologic characteristics,clinical manifestations,impairment of organs,and laboratory findings were compared between the 2 groups and statistic analysis was performed on the available date.Results 1.The rate of KD patients ＜ 1-year-old and the incidence of incomplete KD in the observation group were significantly higher than those in the control group (all P ＜0.01) ; 2.The incidences of rash,changes in oral mucosa,congestion of conjunctiva,hardening edema of hands and feet,lymph node enlargement in the observation group were significantly lower than those in the control group (all P ＜ 0.01) ; 3.Incidence of coronary artery impairment in the observation group was significantly higher than that in the control group (P ＜ 0.05) ; 4.There were no significant differences for inflammation index between the 2 groups (all P ＞ 0.05).Conclusions The incidence of KD and the number of cases with incomplete KD increased in the last decade,especially in younger infants,and the incidence of coronary arteries impairment is increased.To incomplete KD,combining clinical manifestations with laboratory findings of inflammation index are needed for early diagnosis.

Value of antiviral therapy for infectious monocytosis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of antiviral therapy for infectious monocytosis (IM) in children by comparing the near-term therapeutic efficacies and long-term follow-up results in children with this disorder between receiving antiviral therapy or not.</p><p><b>METHODS</b>The medical data of IM children between 1999 and 2009 were retrospectively reviewed. A total of 172 cases with a follow-up visit period of 1 year and more were eligible. The children were classified into three groups according to the treatment protocol: ganciclovir treatment (n=49), acyclovir treatment (n=72) and symptomatic treatment (control; n=51). The children in the ganciclovir group received an intravenous drip of 10 mg/kg per day of ganciclovir, administered in twice-daily doses; Seven days later the drip volume was changed to 5 mg/kg, administered once each day; the total course lasting 10-14 days. The children in the acyclovir group received acyclovir orally at 20 mg/kg per day, administered in three times daily doses; the total course lasting 10-14 days. The children in the control group received symptomatic treatment only. In the three groups, indicators including fever course, improvement of isthmitis symptoms, lymph node retraction, hepatic and splenic lymph node retraction time, atypical lymphocyte fallback time and alteration of granulocyte amount after drug use were observed. The long-term follow-up visits covered such indicators as blood routine reexamination, hepatic function, liver and spleen B-ultrasonography, recovery rate, recurrence rate and mortality rate.</p><p><b>RESULTS</b>In the acute phase, there were no differences in terms of fever course, isthmitis improvement, hepatic and splenic lymph node retraction time and the time of atypical lymphocyte falling back to below 10% among the three groups (P>0.05). During the period of follow-up visits between 1 year and 8 years and 10 months, no significant differences were observed in the recovery rate, the recurrence rate and the mortality rate among the three groups (P>0.05).</p><p><b>CONCLUSIONS</b>The efficacies of antiviral therapy for IM children appear to be similar to non-antiviral therapy, suggesting that antiviral therapy fails to be beneficial for IM children.</p>