The prognostic and predictive value of plasma D-dimer in children with neuroblastoma: a 7-year retrospective analysis at a single institution

Purpose@#Elevated plasma D-dimer level is a poor prognostic factor for many solid tumors. However, limited research has been conducted on D-dimer in children with neuroblastoma (NB), and its clinical significance remains unclear. The present study investigated the clinical and prognostic significance of D-dimer in pediatric NB patients. @*Methods@#A retrospective analysis of all newly admitted NB patients was conducted from January 2014 to December 2020.Baseline clinicopathological features, preoperative laboratory parameters, and follow-up information were collected. Univariate and multivariate analyses were performed to determine the relationship between D-dimer level, clinical features, and the prognostic value. @*Results@#Among 266 patients, the median value of D-dimer was 2.98 ng/mL, of which 132 patients showed elevated D-dimer levels before surgery (>2.98 ng/mL). Univariate analysis revealed that elevated D-dimer was significantly associated with age, hemoglobin, neutrophil-to-lymphocyte ratio, neuron-specific enolase, 24-hour vanillylmandelic acid, overall survival, and so on (P < 0.05). Patients with elevated D-dimer levels had shorter median overall survival time when compared with normal D-dimer levels (P = 0.01). The prognosis was better in patients with normal D-dimer levels when combined with lower age, ganglioneuroblastoma tumor type, lower stage on International Neuroblastoma Staging System, low-risk group, and without bone metastasis or bone marrow metastasis. The continuous increase of D-dimer level after treatment indicated tumor recurrence or progression. @*Conclusion@#A high D-dimer level is associated with low overall survival, and an elevated D-dimer level after treatment indicates tumor recurrence and progression. D-dimer can be used as one of the evaluation factors for NB treatment or prognosis.

Application of Downey classification used in the diagnosis and treatment of children's snakebite / 中华实用儿科临床杂志

Objective To analyze the application of Downey classification and to improve the diagnosis and treatment for children bitten by venomous snakes.Methods The consecutive 76 snakebite children were treated according to the guidance of Downey classification in Children's Hospital of Chongqing Medical University from Jan.2005 to Dec.2011.Their epidemiological and clinical characteristics,treatment and outcomes were reviewed and analyzed.The Chinese traditional classification method was adopted to classify children of snakebites as a contrast at the same time,and the correlation of the 2 methods was studied.Correlations in Downey level,treatment time,length of hospital stay,osteofascial compartment syndrome (OCS) and the occurrence of myocardial damage were studied respectively.Results The 76 cases of snakebites all occurred from Apr.to Nov.,the time of injuries focused on the period of 18:01 to 00:00 (60 cases,78.94％),and limbs were the main injury parts(73 cases,96.05％).According to Downey's system,patients of grade 0 were 3 cases (3.95 ％),grade Ⅰ were 9 cases (11.84％),grade Ⅱ were 26 cases (34.21％),grade Ⅲ were 30 cases (39.47 ％),and grade Ⅳ were 8 cases (10.53 ％).All children victims were given comprehensive and symptomatic treatment,in which 74 cases were clinically cured and 2 cases were disabled,but no deaths.There was positive correlation between the traditional classification method and Downey classification method (r=0.85,P ＜ 0.05),and there was also positive correlation between treatment time and length of hospital stay (r =0.91,P ＜ 0.05).There was positive correlation between Downey level and OCS,the occurrence of myocardial damage,treatment time and length of hospital stay(r =0.90,0.95,0.48,0.96,respectively,all P ＜ 0.05).Conclusions The diagnosis and treatment were more specified after using the Downey classification,snake venom poisoning in children is a medical emergency requiring immediate attention,early diagnosis and proper treatment can reduce its fatality and disability rate.

Protective effects of andrographolide on septic mice and the related mechanism / 第二军医大学学报

Objective To investigate the protective effects of andrographolide on septic mice and to explore the underlying mechanism. Methods Sepsis model was induced by cecal ligation and puncture (CLP) in mice. A total of 64 C57BL/6 mice were evenly randomized into 4 groups: a sham group, a CLP group, a dimethyl sulfoxide (DMSO) group and an andrographolide (AND) group. The mice were injected intraperitoneally withO. 2 mL normal saline, 0.2 mL 5% DMSO or 0. 2 mL andrographolide (10 mg/kg) at 1 h, 6h and 12 h after surgery. The survival rateswere assessed 7 days after surgery and the survival curvewas plotted. Another 48 C57BL/6 mice were grouped as above. The peripheral blood, peritoneal lavage fluid (PLF), lung and liver tissues were harvested 24 h after operation. Polymorphonuclear leukocyte (PMN) count in PLF was determined. Bacterial loads in the peripheral blood sample and PLF were also determined. The levels of TNF-«, IL-6 and IL-10 in the blood samples were detected by ELISA. The lung and liver tissues were observed and analyzed by hematoxylin-eosin staining. Results Compared with CLP group, AND group had a significantly increased survival rate 7 days after operation (P<0. 01), a significantly decreased PMNcount in PLF (P<0. 01), a significantly enhanced bacterial clearance capability in both blood and PLF (P<0. 01), significantly decreased serum TNF-a and IL-6 levels, significantly increased IL-10 level, and significantly alleviated lung and liver tissue injuries (P<0. 01). The above parameters were not significantly different between the DMSO group and CLP group. Conclusion Andrographolide has protective effect against CLP-induced sepsis in mice, which might be associated with regulation of the immunological function, enhancement of bacterial clearance and inhibition of excessive inflammatory response during sepsis.

Synthesis of benzothiazole derivatives and their binding characteristics with beta-amyloid / 药学学报

Alzheimer's disease (AD) is a progressive neurodegenerative disease endangering human health seriously. Recent reports have revealed that beta-amyloid aggregates play a key role in the pathogenesis of AD. Thus, targeting the Abeta plaques benzothiazole derivatives were synthesized with the scaffold of the most promising imaging agent PIB ([11C]-6-OH-BTA-1, [11C]-2-(4-(methylamino)phenyl)-6-hydroxybenzothiazole) and C = N as linker to study the binding characteristics with the target protein through surface plasmon resonance (SPR) technique. These derivatives were synthesized through simple yet effective method with high yields and characterized by 1H NMR and FTIR. The binding properties (K(D)) were determined with Biacore X-100 instrument according to the fitting-plot curve. Compounds 3a and 3f showed high binding affinity for Abeta1-40. The results suggest that benzothiazole derivatives could be served as a scaffold to develop novel beta-amyloid imaging agents for the diagnosis of AD.