Discussion on diagnostic value of urinary neutrophil gelatinase-associated lipocalin in the diagnosis of acute pyelonephritis in children / 天津医药

Objective To explore the diagnostic value of urine neutrophil gelatinase-associated lipocalin (NGAL) in children with acute pyelonephritis. Methods A total of 104 children with urinary tract infection admitted to Tianjin Children's Hospital from December 2016 to May 2017 were selected in this study, including 61 cases with acute pyelonephritis (group APN) and 43 with lower urinary tract infection (group non-APN). The serum levels of beta 2-Microglobulin (β2-MG), cystatin C (CysC), C-reactive protein (CRP), procalcitonin (PCT) and urine levels of NGAL were compared between two groups.Receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic values of serum β2-MG,CysC,CRP,PCT and urine NGAL.Results The serum levels of CRP,PCT,β2-MG and urinary NGAL were significantly higher in APN group than those in non-APN group (P < 0.05). There was no significant difference in serum CysC level between two groups(P>0.05).The areas under the ROC curve(AUC)for serum CRP,PCT,and urinary NGAL were 0.838,0.898 and 0.963.The optimal cutoff value of serum CRP was 22.6 mg/L,the sensitivity was 75.4% and the specificity was 83.7%. The optimal cutoff value of serum PCT was 0.285 μg/L, the sensitivity was 77.0% and the specificity was 93.0%.The optimal cutoff value of urine NGAL was 473 μg/L,the sensitivity was 82.0% and the specificity was 97.7%.Conclusion Urinary NGAL has high diagnostic value for APN in children,and which is helpful for the early identification of APN.

Clinical significance of overexpression of metastasis-associated gene MTA1 in cervical cancer and bioinformatic analysis of genes coordinately expressed with MTA1 / 解放军医学杂志

Objective To analyze the clinical significance of MTA1 overexpression in cervical cancer and bioinformatically screen the potential treatment targets from the gene network correlated with MTA1 overexpression. Methods SPSS software package was used to analyze the correlation of MTA1 with clinical metastasis and pathological grade of cervical cancer based on TCGA-CESC data set. The edgeR software was used to screen the gene set whose expression was correlated with MTA1 in cervical cancer at a global transcriptional level. DAVID platform was adopted to identify the enriched biological functions of the gene set significantly correlated with MTA1 expression. The transcriptional regulation network of the gene set was constructed with STRING online platform and Cytospace softwares to identify the key regulators. Results TCGA-CESC database assay showed a significant positive correlation of MTA1 expression with clinical metastasis of cervical cancer (P<0.01). There was a gene set in which gene expression was closely correlated with MTA1 level. Functional enrichment of the gene set indicated that cancer pathways, stem cell pathways, cell migration, cell differentiation, etc. were closely linked to MTA1-correlated malignant behaviors of cancers. Bioinformatical screening showed that Agt, Acta1, Fpr2, Pmch and RGS18, which are correlated with MTA1 expression in cervical cancer, were the key regulators in differentially expressed gene sets. And these genes were located to the GPCR pathway. Conclusions MTA1 overexpression is significantly correlated with clinical metastasis of cervical cancer and paralleled with the activation of gene regulation involved in stem cell pathway, cytokine receptor signaling, cell migration and differentiation pathways. These genes are correlated with MTA1 expression and potential treatment targets in cervical cancer and should be further experimentally evaluated in the future.

Efficacy and safety of paclitaxel and carboplatin for ovarian cancer: A meta-analysis / 解放军医学杂志

Objective To systematically evaluate the efficacy and safety of paclitaxel and carboplatin dose-dense weekly compared with the same chemotherapeutics administered every 3 weeks for ovarian cancer. Methods The databases, including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), WHO ICTRP, CNKI, VIP and WanFang Data, were electronically searched from inception to February 2016 to collect the randomized controlled trials (RCTs) about dose-dense weekly paclitaxel and carboplatin vs paclitaxel and carboplatin administered every 3 weeks for ovarian cancer. According to the inclusion and exclusion criteria, two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was conducted by RevMan5.3 software. Results A total of 9 studies involving 2723 patients were included. The results of meta-analysis showed that, compared with the conventional treatment group, the dose-dense treatment group could significantly prolong the OS (Overall survival) (HR=0.85, 95%CI 0.73-0.98, P=0.03), but no significant difference existed between the two groups in clinical response (OR=1.13, 95%CI 0.91-1.39, P=0.27), survival (OR=1.10, 95%CI 0.99-1.22, P=0.07) and PFS (progression-free survival) (HR=0.89, 95%CI 0.74-1.06, P=0.18). A significantly higher blood system adverse reaction rate was in dose-dense treatment group than in conventional treatment group (OR=1.68, 95%CI 1.20-2.36, P=0.003); however, significantly lower rates of vomiting (OR=0.67, 95%CI 0.54-0.83) and hair loss (OR=0.57, 95%CI 0.44-0.74, P<0.0001) were in dose-dense treatment group. There were no significant difference existed between the two groups in liver function (OR=1.30, 95%CI 0.88-1.90, P=0.19), kidney function (OR=1.07, 95%CI 0.65-1.77, P=0.79), paresthesia (OR=1.13, 95%CI 0.91-1.41, P=0.26) and ECG (OR=0.74, 95%CI 0.35-1.58, P=0.44). Conclusions Current evidences have shown that dose-dense weekly paclitaxel and carboplatin can prolong the OS, lower the rates of vomiting and hair loss, while no significant difference exist between the two groups in clinical response, survival, PFS, liver function, kidney function, paresthesia and ECG. However, a significantly higher blood system adverse reaction rate may occur in dosedense treatment group than in conventional treatment group.

Alprostadil liposome microsphere preparation stabilizes vascular plaques and inhibits intra-plaque inflammation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vulnerable plaques play an important role in the onset of sudden cardiac events and strokes. How to stabilize vulnerable plaques is still a challenge to medical science. Alprostadil is a biologically active substance with strong activity on vessel. Our study assessed the stabilizing effects of an alprostadil liposome microsphere preparation (ALMP) on vulnerable plaques in the brachiocephalic artery of apolipoprotein E (Apo E) knockout mice.</p><p><b>METHODS</b>Seventy-two male Apo E-knockout mice were fed a high-fat diet beginning at eight weeks of age. At week 17, they were divided randomly into groups for treatment with a high dose (3.6 µg×kg(-1)×d(-1)) or low dose (1.8 µg×kg(-1)×d(-1)) of an ALMP, or 0.2 ml/d normal saline (control group). The drug was administered using a micro-capsule pump. Twenty weeks after drug administration, pathological changes in the vulnerable plaques within the brachiocephalic artery were assessed, and levels of anti-mouse monocyte/macrophage monoclonal antibody (MOMA-2) and superoxide anions in the plaques were detected using immunofluorescence. The soluble intercellular adhesion molecule-1 (ICAM-1) expression was measured by ELISA, and the expression of matrix metalloproteinase-9 (MMP-9) and CD40 mRNA was measured using RT-PCR. Thrombospindin-1 (TSP-1) expression was detected using Western blotting.</p><p><b>RESULTS</b>Compared with the control group, ALMP treatment significantly reduced the plaque area in the brachiocephalic artery (P < 0.01), significantly lowered the contents of the lipid core (P < 0.01), significantly reduced the number of ruptured fibrous caps (P < 0.05), and increased the thickness of the fibrous cap and significantly reduced the incidence of intra-plaque hemorrhage (P < 0.05). ALMP treatment significantly reduced the expression of MOMA-2, superoxide anion, MMP-9, ICAM-1 and CD40 in the plaques (P < 0.01), decreased plasma ICAM-1 expression (P < 0.01), and increased the expression of TSP-1.</p><p><b>CONCLUSIONS</b>Treatment with ALMP can stabilize vulnerable plaques by inhibiting inflammation.</p>

Antibiotic resistance of pathogens isolated from 181 children with complicated urinary tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and antibiotic resistance of pathogens isolated from children with complicated urinary tract infection.</p><p><b>METHODS</b>A retrospective analysis was performed on the distribution and antibiotic resistance of pathogens isolated from 181 children with complicated urinary tract infection (positive urine culture). The antibiotic resistance of common pathogens was determined by the antimicrobial susceptibility test.</p><p><b>RESULTS</b>Gram-negative bacilli were the main pathogens (63.5%), and involved Escherichia coli (E.coli) of 42.0%. Gram-positive cocci accounted for 32.1%, and involved enterococci faecalis of 15.5%. Fungi infection was found in 4.4% of children. The resistance rate of E.coli to ampicillin was the highest (89.4%), but the rate decreased significantly by adding amoxicillin/clavulanic acid (34.2%). E.coli had a high resistance rate to cephazolin, ceftriaxone and cafalotin (>50%), but the resistance rate of E.coli to cefoperazone/sulbouam was significantly lower than other cephalosporins (P<0.01). E.coli was sensitive to imipenem and displayed a lower resistance rate to furadantin (<10%). The resistance rate of enterococci faecalis to rifampicin was high (78.3%), but was low to furadantin, vancomycin and linezolid (<10%). The multiresistant strains accounted for 77.4% of gram-negative bacilli.</p><p><b>CONCLUSIONS</b>E.coli is the major pathogen in children with complicated urinary tract infection, and the enterococci-caused urinary tract infection has been increasing. These pathogens have a high antibiotic resistance, and most of them are multiresistant. Antimicrobial therapy should be based on the results of urine culture and antimicrobial susceptibility test.</p>

Comparison of immunomagnetic beads and hespan precipitation for isolation of mononuclear cells from umbilical cord blood / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the characteristics of immunomagnetic beads and hespan precipitation for isolation of mononuclear cells (MNCs) from umbilical cord blood and try to find a better isolation method for MNCs.</p><p><b>METHODS</b>Fifteen umbilical cord blood samples from healthy parturiens were collected between December 2007 and March 2008. MNCs were isolated using hespan precipitation and CD133 immunomagnetic beads, respectively. MNCs were identified using the surface marker CD34 by flow cytometry on the 30th of primary culture. Growth conditions and morphologic changes of primary cells were observed by an inverted microscope.</p><p><b>RESULTS</b>The number of MNCs from umbilical cord blood isolated by hespan precipitation (15.23 +/- 4.30 x 10(6)/mL) was significantly greater than that by CD133 immunomagnetic beads (0.066 +/- 0.027 x 10(6)/mL) (p<0.05). The MNCs isolated by hespan precipitation suspended at the culture medium and their growth was slow after passage. The growth of MNCs isolated by CD133 immunomagnetic beads was kept in a good condition. The CD34 positive rate of MNCs isolated by hespan precipitation and immunomagnetic beads was 10.1% and 0.5%, respectively.</p><p><b>CONCLUSIONS</b>The hespan precipitation is an effective method for MNCs isolation from human umbilical cord blood, but with a cell growth condition below the mark. The MNCs isolated by CD133 immunomagnetic beads are in a high purity quotient.</p>

The effects of various beta-blockers on myocardial gap junction structure in rat with myocardial ischemia-reperfusion injury / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the effects of carvedilol, metoprolol and propranolol on myocardial gap junction (GJ) structure in rat with myocardial ischemia and reperfusion injury.</p><p><b>METHODS</b>Rats were divided randomly into five groups: sham operation group (SO), myocardial ischemia and reperfusion group (IR), IR + carvedilol group (CV), IR + metoprolol group (MT), and IR + propranolol group (PP). The left anterior descending branch was ligated for 30 minutes and reperfused for 4 hours (IR). After 4 h reperfusion, the distribution and composition of gap junctional connexin 43 (CX43) were observed by immunofluorescence and laser scanning confocal microscopy (LSCM), and the quantification of CX43 was measured by LSCM.</p><p><b>RESULT</b>Compared with SO group, IR resulted in abnormal distribution and composition of CX43-GJ and the impairment of CX43-GJ was significantly attenuated by CV, MT and PP treatments with the best effect observed in CV group (P<0.05 vs. MT and PP).</p><p><b>CONCLUSION</b>These results suggest that beta-blockers, especially, carvedilol, could significantly attenuate IR induced CX43-GJ impairment.</p>

Clinical study on effect of Garlicin in stabilizing the carotid artery atherosclerotic plaque in patients with primary hypertension and coronary artery disease / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).</p><p><b>METHODS</b>Seventy-nine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally.</p><p><b>RESULTS</b>By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P < 0.05).</p><p><b>CONCLUSION</b>Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.</p>

Bacterial pathogens and resistance patterns in community acquired pediatric urinary tract infection: experience of 152 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study investigated the pathogen distribution and resistance patterns in childhood urinary tract infection in order to provide references for optimal use of antibiotics in the treatment of this disorder.</p><p><b>METHODS</b>The clinical data of 152 children with community acquired urinary tract infection (urinary culture positive) between December 2001 and December 2004 were studied retrospectively. The bacterial pathogens of urinary tract infection and antimicrobial resistance were analyzed.</p><p><b>RESULTS</b>Gram-negative bacilli was predominant pathogenic bacteria, accounting for 79.0% of the cases, and Escherichia coli (E. coli) was most commonly found (56.2%). Gram-positive cocci accounted for 18.4%, including 15.1% of Enterococcus faecalis. Fungi was rarely seen, accounting for only 2.6%. E. coli had a resistance rate of more than 50% to ampicillin, amoxicillin/clavulate, co-trimoxazole, cefradine, and fosomycin, but a very low resistance rate (< 4%) to 3rd generation cefalosporin, nitrofurantoi, azactom and amikacin. Enterococcus faecalis had a low resistance rate (< 20%) to ampicillin, vancomycin, penicillin, and nitrofurantoin.</p><p><b>CONCLUSIONS</b>E. coli is the major pathogen in community acquired pediatric urinary tract infection, and Enterococcus has been become another important pathogen. Selection of antibiotics for the treatment of this disorder should base on drug-sensitive test results.</p>

Role of gap junction in ischemic preconditioning / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the role of gap junction in ischemic preconditioning (IPC).</p><p><b>METHODS</b>Sprague-Dawley rats were subjected to a 30 min coronary artery occlusion followed by 4 h of reperfusion (I/R). Rats were divided into seven groups: I/R, IPC/R, IPC/R + 5-hydroxydecanoic acid (mitochondrial ATP sensitive potassium channel antagonist), I/R + diazoxide (mitochondrial ATP sensitive potassium channel agonist), I/R + 5-hydroxydecanoic acid + diazoxide, I/R + 18beta-glycyrrhetinic acid (gap junction blocker) and I/R + 18beta-glycyrrhetinic acid + 5-hydroxydecanoic acid. Hemodynamics and myocardial infarct size were measured and connexin43 phosphorylation and subcellular distribution were determined by quantitative immunoblotting and confocal immunofluorescence.</p><p><b>RESULTS</b>Infarct size was reduced in IPC/R, I/R + diazoxide and I/R + 18beta-glycyrrhetinic acid group (13.34% +/- 7.87%, 11.02% +/- 2.24%, and 15.03% +/- 11.35%, respectively; P < 0.001 vs. I/R group: 45.81% +/- 7.91%). 5-hydroxydecanoic acid abolished the cardioprotective effects of IPC and diazoxide (46.57% +/- 5.36% and 47.36% +/- 3.17%; P > 0.05 vs. I/R) but not the effects of glycyrrhetinic acid (14.60% +/- 7.36%; P < 0.001 vs. I/R). Phosphorylation of connexin43 was significantly increased, dephosphorylation and connexin43 intracellular redistribution significantly decreased (Cx43 size in the cellular membrane 1.00% +/- 0.35% and 0.83% +/- 0.31%, P < 0.001 vs. I/R: 0.19% +/- 0.06%) by IPC and diazoxide and these effects could be abolished by 5-hydroxydecanoic acid.</p><p><b>CONCLUSION</b>Ischemic preconditioning could reduce myocardial infarction size by activating mitochondrial ATP sensitive potassium channel and modulating connexin43 phosphorylation and internalization.</p>

Fosinopril but not metoprolol attenuated the increased matrix metallo-proteinases 9 expression at mRNA and protein levels of human umbilical vein endothelial cells exposed to oscillatory flow / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effect of fosinopril and metoprolol on metalloproteinases 9 (MMP9) expression of human umbilical vein endothelial cells (HUVECs) stimulated by oscillatory flow.</p><p><b>METHODS</b>HUVECs were exposed to steady laminar flow or oscillatory flow, laminar flow or oscillatory flow plus various concentrations (1 x 10(-7) mol/L, 1 x 10(-5) mol/L) of fosinopril and metoprolol for 4 and 24 hours. MMP9 mRNA and protein expressions of HUVECs were determined by RT-PCR and Western blot, respectively.</p><p><b>RESULTS</b>MMP9 expression at mRNA and protein levels were significantly increased in HUVECs exposed to oscillatory flow than that to laminar flow and these could be down-regulated by coincubation with fosinopril (1 x 10(-7) mol/L, 1 x 10(-5) mol/L, P < 0.01, P < 0.05, respectively) but not by co-incubation with metoprolol.</p><p><b>CONCLUSION</b>Fosinopril can attenuate the increased MMP9 expression at mRNA and protein levels of HUVECs exposed to oscillatory flow.</p>

Effects and the mechanism of carvedilol on gap junctional intercellular communication in rat myocardium / 中华心血管病杂志

<p><b>OBJECTIVE</b>To examine the effects of carvedilol on myocardial ischemia and reperfusion injury and on gap junctional intercellular communication (GJIC).</p><p><b>METHODS</b>The left coronary artery was occluded for 30 min and reperfused for 4 h. The activity of creatine phosphokinase (CK), lactate dehydrogenase (LDH) and the infarct size were measured. Isolated buffer-perfused hearts were divided randomly into four groups, sham operation (SO), myocardial ischemia and reperfusion (IR), carvedilol (CV) and heptanol (a gap junctional inhibitor) (HT). The effect of carvedilol on GJIC was measured by a modification of Scrape-loading and dye transfer method, and the state of CX43 phosphorylation was evaluated by Western blot.</p><p><b>RESULTS</b>Compared with the SO group, Increased CK, LDH and infarct size were found in the IR group after 4 h reperfusion. GJIC in the IR group was not inhibited, but dephosphorylated CX43 was increased after 30 minutes of ischemia. Carvedilol decreased CK, LDH and infarct size compared with the IR rats; after 30 minutes of ischemia, both carvedilol and heptanol significantly reduced the GJIC, associated with a significant augmentation of dephosphorylated CX43.</p><p><b>CONCLUSIONS</b>These results suggest that carvedilol reduces GJIC during ischemia presumably by dephosphorylating Cx43, which may be one of the mechanisms of lessening myocardial ischemia-reperfusion injury.</p>