Serum levels of leptin and several growth-related hormones in premature infants / 中华儿科杂志

<p><b>OBJECTIVE</b>Leptin (LEP) is mainly produced by white adipose tissue and participates in the energy metabolism and regulation of growth. Cooperating with the other metabolic hormones, it plays an important role in the developments of fetus and neonates. This study was designed to test the serum levels of LEP, neuropeptide Y (NPY), insulin (INS) and insulin-like growth factor-1 (IGF-1) and measure the body mass index (BMI) and head circumference (HC) at different days of life of premature infants with or without serious diseases and to find the changes of serum levels of LEP as well as NPY, INS and IGF-1, the relationship between those hormones and the changes of body weight and the influences of diseases on the levels of those hormones in premature infants.</p><p><b>METHOD</b>The clinical data as well as weights, lengths, HC of 40 sick premature infants (sick group) and 30 premature infants without any diseases (control group) were collected and the serum levels of LEP, NPY, INS and IGF-1 were determined by using radioimmunoassay (RIA) at d 1, d 7 and d 12 of life. BMI was calculated by weight (kg)/length (m)(2). SPSS13.0 was used to analyze the data</p><p><b>RESULT</b>(1) In sick group the serum LEP levels were 0.74 +/- 0.21, 0.60 +/- 0.18, 0.82 +/- 0.12 (mg/L) (P < 0.01), the BMI were 9.81 +/- 1.24, 8.36 +/- 0.87, 9.08 +/- 1.12 (kg/m(2)) (P < 0.01) on d 1, d 7 and d 12, respectively. In control group serum LEP levels were 0.78 +/- 0.17, 0.71 +/- 0.17, 0.88 +/- 0.58 (mg/L) (P < 0.01), the BMI were 10.03 +/- 1.04, 9.35 +/- 0.80, 11.06 +/- 0.82 (kg/m(2)), on d 1, d 7 and d 12, respectively (P < 0.01). In both groups, serum LEP levels as well as the BMI decreased on d 7 and reincreased on d 12. The differences of serum LEP levels and BMI between sick group and control group at d1 were not significant (P > 0.05); compared with control group, the serum LEP levels and BMI on d 7 and d 12 in sick group were lower and the differences were significant. (2) There were positive correlations between serum LEP levels and BMI in sick group as well as in control group. (3) In sick group, the serum NPY levels at d 1, d 7, d 12 were 55.33 +/- 9.38, 46.64 +/- 6.17, 75.13 +/- 9.12 (ng/L) (P < 0.01), INS were 10.07 +/- 2.63, 7.71 +/- 2.77, 10.37 +/- 2.29 (mU/L) (P < 0.01), IGF-1 were 38.66 +/- 11.42, 31.98 +/- 7.34, 41.84 +/- 8.05 (mg/L) (P < 0.01), respectively. In control group, the serum NPY levels at d1, d 7 and d 12 were 57.77 +/- 7.15, 48.49 +/- 8.81, 81.36 +/- 8.51 (ng/L) (P < 0.01), INS were 11.55 +/- 1.99, 8.28 +/- 2.87, 15.42 +/- 3.80 (mU/L) (P < 0.01), IGF-1 were 37.76 +/- 7.07, 34.33 +/- 8.97, 50.19 +/- 8.38 (mg/L) (P < 0.01), respectively. In both groups, serum levels of NPY, INS and IGF-1 had positive correlations with serum LEP levels as well as BMI on the corresponding days and decreased on d 7 and reincreased on d 12.</p><p><b>CONCLUSION</b>(1) The serum LEP levels decreased on 7 d of life and reincreased on 12 d of life, which corresponded to the changes of the physical development of premature infants. (2) The serum LEP levels in sick premature infants decreased definitely as compared with control group, which suggested that diseases had negative influences on the LEP levels and the physical developments were slowed down in sick premature infants. (3) The serum levels of NPY, INS and IGF-1 had positive correlations with LEP levels as well as BMI at the early period of life, which suggested that NPY, INS and IGF-1, cooperating with LEP, might take part in the regulation of development of premature infants.</p>

Value of multi-slice spiral CT in the diagnosis of closed thyroid cartilage injury / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application and to evaluate the value of multi-slice spiral computed tomography (MSCT) in closed thyroid cartilage injury.</p><p><b>METHODS</b>MSCT scan was performed in 5 patients with closed thyroid cartilage injury, and 2D and 3D images reconstructions were achieved after volume data was transferred to workstation.</p><p><b>RESULTS</b>In 5 cases, the thyroid cartilage fracture was found in left board in 4 patients, in right board in 1 patient. In addition, one patient had concurrent cricoid cartilage fracture and another patient had laryngotracheal stenosis. These fractures and changes were all visualized by 2D and 3D images. Lower window level and window width were helpful to reveal the structures of thyroid cartilage. Multi-planar reconstruction (MPR) was superior in displaying alignment and displacement of fracture in 4 cases. 3D-volume reconstruction (3D-VR) was accurate in displaying space change of cartilage structures. In 3 cases, the evaluation of 3D-VR was accurate in assessing the length, width and shape of fracture, providing helpful data for the clinician to adopt the optimal management Computed tomography virtual laryngoscope (CTVL) helped to offer the criterions to the diagnosis of upper airway stricture and the location of laryngotracheal stenosis in one case.</p><p><b>CONCLUSIONS</b>MSCT was useful in the diagnosis and management of closed thyroid cartilage injury and the laryngotracheal stenosis. It was believed that the reasonable use of the reprocessing technique plays an important role in the diagnosis, treatment and evaluation of the effect of closed thyroid cartilage injury.</p>

Na+-H+ exchanger protein changes in vascular smooth muscle and effect of Na+-H+ exchange inhibitor on vessel stenosis after balloon injuries in rabbits / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the mechanism and effect of sodium/hydrogen exchanger (Na(+)-H(+) exchanger, NHE), amiloride, on vessel stenosis.</p><p><b>METHODS</b>Thirty-two adult male New Zealand white rabbits were randomly divided into groups of amiloride intervention (IG, n = 12), balloon injury (BG, n = 10) and sham-operation (SG, n = 10). A 2.5 mm x 20 mm Foley's tube was used to injury left side iliac artery in the IG and BG groups, whereas a same Foley's tube was inserted into the vessel without any injuries in the SG group. Amiloride (5 mg.kg(-1).d(-1)) was intraperitoneally injected 3 days before balloon injuries and the same dosage normal saline was used in the same way in the BG group for 28 days after operation. The rabbits were killed and the iliac arteries were stained with Hematoxylin-Eosin, alpha-actin and Masson's trichrome to observe the morphologic changes in the vessel cava, neointima, media layer, and vascular smooth muscle cells (VSMCs) migration into the neointima and extracellular matrixes (ECMs).</p><p><b>RESULTS</b>Four weeks after balloon injuries in rabbits, a cave narrow of the iliac artery and neointima were found and the media layer (VSM layer) was proliferated. The quantities of NHE-1 protein from artery smooth muscle in all the groups were 0.21 +/- 0.02, 0.25 +/- 0.04 and 0.11 +/- 0.03 (P < 0.01), respectively. The difference between the BG and SG groups was significant, which indicated that the NHE-1 proteins increased after balloon injury. The quantities of NHE-1 protein from the IG group were lower than those from the BG group. The cave areas were 0.91 mm(2) +/- 0.23 mm(2), 0.68 mm(2) +/- 0.19 mm(2) and 1.08 mm(2) +/- 0.17 mm(2) (P < 0.01), respectively. The intima areas were 0.27 mm(2) +/- 0.15 mm(2), 0.67 mm(2) +/- 0.24 mm(2) and 0.05 mm(2) +/- 0.03 mm(2), respectively (P < 0.01). The ratios of intima to media area were 1.21 +/- 0.24, 1.39 +/- 0.26 and 0.15 +/- 0.08 (P < 0.01), respectively. Amiloride increased vessel cave areas, but decreased intima areas and intima to media ratios in the IG group. In the IG group, alpha-actin positive areas in neointima was higher (16,328.31 microm(2) +/- 6220.27 microm(2)) than those in the SG group (4164.15 microm(2) +/- 1788.37 microm(2)) (P < 0.01). ECMs areas in neointima in the IG group were lower (8910.62 microm(2) +/- 7041.62 microm(2)) than those in the SG group (33,358.76 microm(2) +/- 7290.17 microm(2)) (P < 0.01).</p><p><b>CONCLUSIONS</b>Balloon injuries of iliac artery in rabbits induce VSMCs proliferation, migration, narrowed cave and vessel stenosis. Amiloride, a NHE-1 inhibitor, may relieve this vessel stenosis.</p>

Changes of P-selectin and E-selectin in children with Kawasaki disease / 中华儿科杂志

<p><b>OBJECTIVE</b>Kawasaki disease (KD) is a kind of febrile disorder without definite etiology. The pathologic change of KD is characterized by nonspecific vasculitis, which mainly involves the coronary artery. Some patients may have coronary angioma formation, and some of them will result in the coronary narrowing or embolism. Notwithstanding that KD has been one of the most common causes for acquired heart diseases in childhood in addition to the rheumatic fever, the pathogenesis of the vascular damage remains unknown. This study was conducted to explore the pathophysiological role of cell adhesion molecules (P-selectin and E-selectin) on the endothelial lesions in KD, and to look for the evidence of direct relationship between the plasma levels of soluble cell adhesion molecules (P- and E-selectin) and the incidence of the coronary artery lesion (CAL).</p><p><b>METHODS</b>Soluble P-selectin (PS), E-selectin (ES), thromboxane-B(2)(TXB(2)), 6-keto-PGF(1)alpha (6-KPGF(1)alpha) were measured in 36 patients with KD, 20 patients with febrile disease and 30 healthy children by using double antibody sandwich enzyme linked immunosorbent assay (ELISA) and radioimmunoassay. Patients with KD were separated into acute phase group, subacute phase group, recovery phase group, coronary artery lesion group (CAL), non-coronary artery lesion group (NCAL), intravenous immunoglobulin (IVIG) effective group (body temperature back to normal after 48 hours of using IVIG), and IVIG ineffective group.</p><p><b>RESULTS</b>Plasma PS and ES levels in the acute phase group [(211 +/- 28 and 186 +/- 14) ng/ml], subacute phase group [(238 +/- 27 and 151 +/- 13) ng/ml] and recovery phase group [(198 +/- 21 and 1008 +/- 9) ng/ml] were significantly higher than those in the healthy group [(102 +/- 36 and 72 +/- 10) ng/ml, P < 0.01]. The plasma PS levels remained higher after the treatment, but in IVIG effective group, the PS and ES levels declined significantly (P < 0.01) compared with those in acute phase group. Plasma PS and ES levels of CAL group [(281 +/- 78 and 210 +/- 52) ng/ml] were significantly higher than those of NCAL group [(217 +/- 15 and 108 +/- 10) ng/ml, P < 0.01]. In contrast to 1 week after the treatment, the PS and ES in IVIG effective group at the time point of 2 weeks after the treatment decreased more significantly (P < 0.01). While the PS and ES in IVIG ineffective group remained higher at the time point of 2 weeks after the treatment, which showed no significant difference compared with those 1 week after the treatment (P > 0.05). One week after the treatment, the PS levels of IVIG effective and ineffective groups did not descend, and there was no significant difference in PS between these two groups at this time point. Two weeks after the treatment, the PS and ES in IVIG ineffective group remained higher than those in IVIG effective group, and there was a significant difference between them. The peak level of PS appeared in the subacute phase. TXB(2) levels of KD in acute phase group increased markedly, which were significantly higher than those of healthy group [(345 +/- 127 and 190 +/- 69) ng/L, P < 0.01]. There was no significant difference between subacute phase group and healthy group. No significant difference was found between CAL group and NCAL group (P > 0.05). The levels of TXB(2) declined quickly after the treatment. The 6-KPGF(1)alpha level in KD of acute phase group, subacute phase group and recovery phase group [(7.1 +/- 2.8, 10.8 +/- 3.7 and 11.3 +/- 4.0) ng/L, respectively] was significantly lower than that of healthy group [(17.7 +/- 5.8) ng/L, P < 0.01], and the levels did not recover to normal even 2 weeks after the treatment. There was no significant difference 6-KPGF(1)alpha levels between CAL group and NCAL group (P > 0.05). In the febrile group, PS and ES levels showed no significant differences compared with healthy children (P > 0.05). ES level of KD patients was significantly correlated with CRP levels (r = 0.79 P < 0.01). In febrile group, there was no significant correlation between ES and CRP. There was a significant correlation between PS and PLT levels in KD patients (r = 0.75 P < 0.01), and no significant correlation between PS and PLT levels in febrile patients.</p><p><b>CONCLUSION</b>The increase of plasma PS and ES levels in KD acute phase and subacute phase might play an important role in the pathophysiology of the endothelial damage. E- and P-selectin may potentially be a predictor of CAL in patients with KD.</p>