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Objective To investigate the therapeutic effect of low molecular weight heparin on adjuvant treat-ment of Mycoplasma pneumoniae pneumonia (MPP)with elevated D-dimer in children,and to summarize the clinical features of MPP with elevated D-dimer in children. Methods Ninety-three cases of MPP with elevated D-dimer in the Affiliated Children′s Hospital of Capital Institute of Pediatrics from January 2015 to October 2016 were randomly di-vided into the high dose group,the low dose group and the non-heparin group. All patients in 3 groups were given ac-tive anti-infection and other conventional treatment. High dose group was given subcutaneous injection of low molecu-lar weight heparin 100 IU/ kg,q12h,treatment for 5 days or D-dimer returned to normal;Low dose group was given subcutaneous injection of low molecular weight heparin 50 IU/ kg,q12h for 5 days,and then D-dimer returned to nor-mal;non-heparin group was given anti-infection and other conventional treatment. Contrast observation was performed among 3 groups for clinical symptoms and chest imaging changes before and after treatment. Also,the hospitalization days and financial costs among 3 groups were compared and the adverse reactions were observed. Another 31 patients of MPP with normal D-dimer were randomly selected for comparison with non-heparin group,including C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and other inflammatory markers,clinical symptoms,chest imaging changes,hospitalization days and the costs. Results (1)The inflammatory indicators such as CRP [(33. 49 ± 31. 75)g/ L],ESR [(34. 59 ± 16. 25)mm/ 1h],cough improvement time [(7. 77 ± 2. 85)d],heat back time [(5. 87 ± 2. 88)d],hospitalization days[(10. 87 ± 3. 50)d],hospital costs[(15455. 91 ± 4086. 95)yuan],and chest imaging severity[the ratio of large-area shadowing to small-area shadowing in terms of chest image severity was (13 / 16 cases)]of MPP with elevated D-dimer group were higher than those of MPP with normal D-dimer group [(14. 83 ± 18. 97)g/ L,(25. 33 ± 20. 35)mm/ 1 h,(3. 90 ± 1. 08)d,(2. 81 ± 1. 99)d,(5. 26 ± 1. 84)d, (7659. 85 ± 2216. 69)yuan,5 / 23 cases],and the differences were statistically significant(Z =-2. 99,- 2. 06,- 5. 82,- 5. 21,- 6. 20,t = 12. 73,χ2 = 4. 80,all P < 0. 05). (2)The time of improvement of cough,chest imaging im-provement time and the hospitalization days in the heparin-treated group[those in the low dose heparin group were (5. 48 ± 1. 95)d,(13. 84 ± 9. 18)d,(9. 19 ± 5. 10)d,and those in the high dose heparin group were(5. 35 ± 1. 91)d,(12. 88 ± 10. 81)d,(8. 58 ± 2. 81)d]were lower than those in the non-heparin group[(7. 77 ± 2. 85)d, (18. 54 ± 10. 13)d,(10. 87 ± 3. 50)d],and the differences were statistically significant(all P < 0. 05),but no signi-ficant difference was found in different doses of heparin (all P > 0. 05). D-dimer and fibrinogen degradation product (FDP)after treatment in the high dose heparin-treated group [(258. 00 ± 516. 00)ng/ L,(2. 25 ± 7. 45)mg/ L] were significantly lower than those in the non-heparin group[(1. 00 ± 691. 00)ng/ L,(0. 70 ± 3. 10)mg/ L],and the diffe-rences were statistically significant(Z = 6. 41,6. 54,all P < 0. 05). Conclusions (1)Compared with the children with MPP with elevated D-dimer,MPP children with normal D-dimer in children have more severe clinical symp-toms,higher inflammatory indicators and more serious chest imaging performance. (2)Low molecular weight heparin on adjuvant treatment of elevated D-dimer children with MPP can significantly improve the clinical symptoms and pro-mote absorption of lung disease,shorten hospitalization days,reduce hospital costs. There is no adverse reaction with short-term application. It is worthy of further promotion.
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Objective To investigate the role of gamma-aminobutyric acid transporter-1 (GAT-1) in the spinal cord in a rat model of bone cancer pain.Methods Eighty female SD rats weighing 150-180 g were randomly divided into 5 groups (n =16 each): sham operation group(group Ⅰ ),bone cancer pain group(group Ⅲ ),sham operation+ NO-711 group(group Ⅲ ),Ⅳ group BCP + NO-711 group(group Ⅳ ) and BCP + vehicle group (group Ⅴ ).Bone cancer pain was induced by inoculating Walker-256 mammary gland carcinoma cells into medullary cavity of tibia.NO-711 (20 μg,10 μl) was administered intrathecally once a day for 3 consecutive days from the 14th day after operation.Mechanical withdrawl threshold (MWT) of mechanical stimulus was determined the day before operation and at days 3,5,7,10,14 and 16 after operation.The animals were sacrificed on the 16th day after operation,and then the spinal cords were removed for determination of the expression of GAT-1 and double immunostaining of GAT-1 and glial fibrillary acidic protein (GFAP,astrocyte marker).Results MWT were significantly decreased in groups Ⅱ,Ⅳ and Ⅴ as compared with groups.Ⅰ and Ⅲ.The expression of GAT-1 significantly up-regulated in groups Ⅱ,Ⅴ as compared with groups Ⅰ and Ⅲ.NO-711 significantly increased MWT,while decreased the expression of GAT-1 in group Ⅳ compared with groups Ⅱ and Ⅴ.The expression of GAT-1 up-regulation appeared colocalizes with in astrocytes activation in spinal dorsal horn.Conclusion The up-regulation of expression of GAT-1 in spinal cord is involued in the development and maintenance of bone cancer pain,which may be related to the astrocytes activation.
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Objective To investigate the role of A2B adenosine receptor(A2BAR)in 6% HES 130/0.4-induced reduction of pulmonary capillary permeability in a rat model of sepsis.Methods Fifty male SD rats weighing 250-300 g were randomly divided into 5 groups(n = 10 each): group Ⅰ sham operation(group S);group Ⅱ sepsis(group CLP);group Ⅲ ,Ⅳ,Ⅴ low,medium,high dose HES(group H1,2,3).The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg.Left carotid artery and left femoral vein were cannulated for MAP and HR monitoring and fluid and drug administration.Sepsis was induced by cecal ligation and puncture (CLP).6% HES 130/0.4 7.5,15.0 and 30.0 ml/kg were infused iv over 2 h in group H1,2,3 respectively at 4 h after CLP.The animals were sacrificed at 6 h after CLP.The lungs were isolated for determination of pulmonary capillary permeability(by iv Evans blue injection),the expression of A2BAR and the contents of cAMP,protein kinase A(PKA),TNF-α,IL-6 and IL-10 in the lung tissue.Results CLP significantly increased pulmonary capillary permeability,A2BAR expression and cAMP,IL-6 and TNF-α contents in the lung tissue in group Ⅱ as compared with group S.0.6% HES 130/0.4 significantly reduced pulmonary capillary permeability,increased A2BAR expression,cAMP,PKA and IL-10 and decreased IL-6 and TNF-αcontents in the lung tissue in group H1,2,3 as compared with group CLP.6% HES 130/0.4 decreased pulmonary capillary permeability and up-regulated A2BAR expression in a dose-dependent manner.6% HES 130/0.4 15.0 ml/kg was most effective in increasing cAMP and PKA contents in the lung and depressing inflammatory response.Conclusion 6% HES 130/0.4 decreases pulmonary capillary permeability in a rat model of sepsis by up-regulating A2BAR expression in lung tissue.