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Epidemiologic, clinical and imaging data were collected from 14 children with confirmed coronavirus disease 2019 (COVID-19) admitted in Beijing Ditan Hospital from January 27, 2020 to February 12, 2020. There were 6 boys and 8 girls with a median age of 3.5 years (6 months-9.4 years). Four patients had a history of travel to Wuhan City or Hubei Province and 2 patients had contacted with people from Wuhan; 13 patients were familial cluster of infection. The incubation period was 4 to 16 days. The clinical manifestations were fever in 8 cases, cough in 5 cases, diarrhea in 1 case; and 2 cases were asymptomatic. Four patients had abnormal peripheral blood routine, including 1 had lymphocytosis, 3 had lymphocytopenia; 3 patients had a slightly elevated CRP, and 3 patients had hepatic dysfunction. Thirteen patients underwent chest CT; and 1 case showed bilateral lung glass exudation, 1 case showed multiple patchy high density shadows of bilateral lung. One patient underwent chest X-ray examination, which was showed no abnormal findings. The pediatric patients with COVID-19 in this series generally have a traceable epidemiological history. The clinical manifestations are fever, cough and diarrhea. Peripheral white blood cell counts were most normal. Chest CT reveals less severe changes than those in adults, most child patients show no manifestation of pneumonia.
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Objective To investigate the antidepressant effects of Chaihu Shugan Powder(CSP) on depressive rats induced by reserpine and its influences on the kynurenine (KYN),indoleamine 2,3-dioxyge-nase(IDO),interleukin-6(IL-6) and tumor necrosis factor-α( TNF-α). Methods Forty rats with similar behavior results were divide into 4 groups randomly,including Control group(Con),Model group(Res),Flu- oxetine group(Res+Flu) and Chaihu Shugan Powder group(CSP). The depressive rat model was established by intraperitoneal injection reserpine. The rats in Res+Flu group were administered with fluoxetine by intrap-eritoneal and rats in Res+CSP group were administered with CSP by intraperitoneal. After 14 days,the be-havior of rats was measured and then the rats were executed and sampled. The content of tryptophan and kynurenine in raphe nuclei tissue were detected. The mRNA expression level of IDO,IL-6,TNF-α in raphe nuclei tissue were detected. Results ( 1) Compared with Con group (( 81. 81 ± 36. 13) s, ( 83. 51 ± 5. 34)%), the swimming immobility time((150. 50±31. 45)s) in Res group increased(t=68. 7, P<0. 05) and the sucrose perference (59. 73±11. 30)%) in Res group decreased(t=23. 8,P<0. 05). Compared with Res group, the swimming immobility time in Res+Flu group((114. 90± 14. 29) s) and Res+CSP group ((111. 7±11. 34)s) decreased(t=35. 6,35. 8,both P<0. 05). Compared with Res group, the sucrose pref-erence in Res+Flu group((78. 21±10. 07)%) increased(t=18. 3, P<0. 05). (2)Compared with Con group (KYN/TRP:(0. 023±0. 016),IDO mRNA:(1. 00±0. 05),IL-6 mRNA:(1. 00±0. 58),TNF-α mRNA:(1. 00±0. 32)), the activity of IDO(KYN/TRP(0. 039±0. 003)) and the mRNA levels of IDO mRNA(3. 63± 0. 31),IL-6 mRNA(2. 36±0. 23),TNF-α mRNA( 3. 56± 0. 14) of Raphe Nuclei tissue in Res group were significantly increased (t=21. 2,12. 9,38. 3,19. 7,all P<0. 05). Compared with Res group, the activity of IDO(KYN/TRP(0. 030±0. 013)),the mRNA expression levels of IDO mRNA( 1. 56±0. 36),IL-6 mRNA (1. 62±0. 16),TNF-α mRNA(2. 64±0. 20)of Raphe Nuclei tissue in Res+Flu group were significantly de-creased(t=38. 8,15. 8,12. 8,26. 4,all P<0. 05). And compared with Res group,the activity of IDO( KYN/TRP(0. 028±0. 021)) ,the mRNA expression level of IDO mRNA( 1. 33± 0. 29),IL-6 mRNA(1. 36± 0. 34),TNF-α mRNA(1. 93±0. 21)of raphe nuclei tissue in Res+CSP group were also significantly decreased (t=23. 21,17. 3,19. 8,29. 8,all P<0. 05). Compared with Res+Flu group,the level of IDO mRNA and in-flammatory factors' mRNA in Res+CSP group were significantly decreased(t=18. 3,20. 8,31. 5,all P<0. 05). Conclusion Chaihu Shugan Powder has antidepressant effect,and the mechanism is related with de-creasing the inflammatory factors,inhibiting IDO activation and decreasing the IDO mRNA.
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Objective To investigate the effects of acute reserpine-induced pain and depression co-morbidity model on behavior and related inflammatory cytokines in rats. Methods Twelve male 8-week-old SD rats were randomly divided into control group and model group,6 in each group. Rats in the model group were intraperitoneally injected with reserpine(1 mg/kg/d)for 3 days to establish the model. Rats in the con-trol group were injected with the same amount of distilled water. The pain threshold of rats was measured by Von Frey Hairs and Hot Plate Analgesia Test. The depression behavior of rats was evaluated by open-field test,Forced Swimming Test and Sucrose Consumption Test. Serum IL-1β, IL-6, IL-18 and TNF-α content were detected by ELISA. Results Compared with the control group(1d (15. 00±0. 00) g;3d ( 13. 20±4. 03)g),the PWTs of the model group (1d (6. 20±0. 45) g;3d (4. 20±1. 64) g) decreased significantly(t=44. 00,4. 63,both P<0. 05). Compared with the control group (( 8. 82 ± 1. 08) s),the PWTL (( 3. 16 ± 0. 24)s) was significantly reduced on the first day in model group,and the difference was statistically signifi-cant (t=11. 48,P<0. 05). Compared with the control group (( 1 815. 18± 541. 40) cm,(98. 20± 26. 25) s, (87. 78±9. 38)g),the total distance of the open-field test ((948. 91±494. 35)cm)significantly shortened (t=2. 64,P<0. 05),swimming time ((143. 60±21. 45)s) was significantly prolonged (t=-2. 65,P<0. 05), and the sucrose consumption (( 22. 23 ± 6. 97) g) significantly decreased (t=12. 55,P<0. 05) in model group. Compared with the control group (( 285. 80 ± 11. 93) ng/ml, ( 233. 07 ± 8. 47) ng/ml,( 280. 41 ± 14. 31) ng/ml,( 213. 10 ± 33. 87) ng/ml), serum levels of IL-1β, IL-6, IL-18, TNF-α in model group ((471. 23±24. 15) ng/ml,(364. 82±17. 16) ng/ml,(471. 81± 28. 98) ng/ml,(821. 19±93. 16) ng/ml) increased significantly(F=-15. 39,-15. 39,-13. 24,-13. 72,all P<0. 05). Conclusion A large number of intraperitoneal injections of acute reserpine can cause hyperalgesia,depressive behavior and serum inflamma-tory factors in rats,effectively simulating the symptoms of pain and depression,and can be used as a model of pain and depression comorbidity for biological mechanisms and treatment research.
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AIM:To study the effect of Taxol on the proliferation, apoptosis, and mRNA expressions of α2,6-sialic acid (SA) and α2,6-sialyltransferase (ST6Gal) in mouse cervical cancer cell line U14.METHODS:After the U14 cells were treated with Taxol, the IC50 value of Taxol to U14 cells was detected by MTT assay.The expression of α2,6-SA and apoptosis-related factors (Bcl-2, Bax, caspase 8 and caspase 3), the apoptosis rate and cell cycle were determined by flow cytometry.The mRNA expression of ST6Gal1 and ST6Gal2 was detected by qPCR.RESULTS:As compared with control group, Taxol induced obvious U14 cell growth inhibition, reduced α2,6-SA expression, up-regulated Bax, down-regulated Bcl-2, decreased the ratio of Bcl-2/Bax, enhanced caspase 8 and caspase 3 activity, increased the apoptotic rate and cell proportions of Sub-G1 and S phases, and induced G2/M phase arrest.Taxol also down-regulated the mRNA expression of ST6Gal1, and slightly up-regulated the mRNA expression of ST6Gal2.CONCLUSION:α2,6-SA and ST6Gal are involved in the multiple effects of Taxol on modulation of the cell cycle and apoptosis in U14 cells.
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Objective To analyze the urodynamic data of the patients with benign prostatic hyperplasia(BPH)and provide evidence for the therapy.Methods 452 patients with BPH were selected.The mean age was(65.6 ±5.65)years(51 to 89 years).All patients had intact history documents which included the results of cystoscopy,urodynamics,doppler,DRE and PSA.Results 15 cases were not diagnosed with BOO.430 cases were diagnosed with BOO,among them,65 cases of bladder detrusor muscle weakness,bladder detrusor instability(detrusor,DI,instability)in 365 cases,3 cases were normal,and the other 4 cases had detrusor atony.In 445 patients the mean maximum urinary flow rate(8.32±3.15)ml/s,the average residual urine volume(87.68±79.46)ml,the average maximum flow rate when the detrusor pressure(62.32±7.54)cm H2O,maximum urethral closure pressure was(86.43±18.35)cmH2O,among which 19 cases were not suitable for surgery.At the end of the 426 patients underwent surgical treatment,postoperative follow-up of 3 to 18 months,the International Prostate Symptom Score(IPSS)from 0 to 5,the quality of life index(QOL)score of 0 to 1,Qmax 11 to 21 ml /s,residual urine(45.6±36.2)ml.There were significant differences between the preoperative and postoperative indexes(P<0.05).Conclusion Urodynamic tests can avoid the blindness in the surgery treatment of BPH.
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Objective To compare the efficacy of different sedation depths of monitored anesthesia care (MAC) in vitrectomy.Methods Ninety-six patients of both sexes,aged 40-64 yr,with body mass index ≤ 35 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective vitrectomy,were randomly divided into 2 groups (n =48 each) using a random number table:mild sedation group (group Ⅰ) and profound sedation group (group Ⅱ).Anesthesia was induced with iv midazolam 0.02 mg/kg and sufentanil 0.15 μg/kg.Anesthesia was maintained with iv infusion of propofol 0.5-2.0 mg · kg-1 · h-1 maintaining bispectral index (BIS) value＞80 in group Ⅰ,or with iv infusion of propofol 2-6 mg · kg-1 · h-1 maintaining BIS value at 65-80 in group Ⅱ.The occurrence of unexpected head movement,SPO2＜90％,snoring,and oculocardiac reflex during the procedure,postoperative nausea and vomiting,and the time when the patients in supine position were turned to prone position were recorded after surgery.Results Compared with group Ⅰ,the incidence of unexpected head movement,SpO2 ＜90％,and snoring was significantly increased,and the time when the patients in supine position were turned to prone position was prolonged (P＜0.05),and no significant difference was found in the incidence of postoperative nausea and vomiting and oculocardiac reflex during the procedure in group Ⅱ (P＞0.05).Conclusion Mild sedation of MAC (BIS value ≥ 80) provides better efficacy than profound sedation (BIS value 65-80) when used for vitrectomy.
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Objective To evaluate the role of p38MAPK signaling pathway in electroacupuncture (EA)-induced reduction of acute lung injury (ALI) in rabbits with endotoxic shock and the relationship with nuclear factor E2-related factor 2 (Nrf2).Methods Seventy healthy male New Zealand white rabbits,aged 2 months,weighing 1.5-2.5 kg,were randomly divided into 7 groups (n=10 each) using a random number table:control group (group C),endotoxin-induced ALI group (group A),p38MAPK inhibitor SB203580 group (group SB),ALI + SB203580 group (group A-SB),ALI + EA group (A-EA group),ALI + EA at non-acupoint group (A-NEA group) and ALI + EA at acupoints+ SB203580 group (A-EA-SB group).The rabbits were anesthetized with urethane and tracheostomized and kept spontaneous breathing.Right common carotid artery was cannulated for mean arterial pressure monitoring.The auricular vein was cannulated for drug administration.Bilateral 30 min EA (wave length 0.2-0.6 ms,frequency 2/100 Hz,intensity ≤ 1-2 mA) stimulation of Zusanli and Feishu was performed once a day for 4 days before establishment of the model and during establishment of the model in A-EA and A-EA-SB groups.In group A-NEA,EA was performed at the points 0.5 cm lateral to the acupoints of Zusanli and Feishu according to the method previously described in group EA.In A,A-SB,A-EA,A-NEA and A-EA-SB groups,ALI was induced by endotoxin (5 mg/kg) injection,while the equal volume of normal saline was given in C and SB groups.After establishment of the model,SB203580 5 μmol/kg was injected intravenously in SB,A-SB and A-EA-SB groups,the equal volume of normal saline was given in group C,and the equal volume of dehydrated alcohol was given in the other groups.At 6 h after endotoxin or normal saline administration,arterial blood samples were collected for blood gas analysis.The rabbits were then sacrificed,and lungs were removed for microscopic examination and for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,and expression of phosphor-p38MAPK (p-p38MAPK) and Nrf2 in lung tissues.The pathological changes of lungs were scored.Wet to dry lung weight ratio (W/D ratio) was calculated.Results Compared to group C,the pathological scores,W/D ratio,MDA content,and expression of pp38MAPK and Nrf2 were significantly increased,and SOD activities were decreased in A,A-SB,A-EA,ANEA and A-EA-SB groups.Compared to group A,the pathological scores,W/D ratio and MDA content were significantly decreased,and SOD activities and expression of p-p38MAPK and Nrf2 were increased in A-EA group.Compared to group A-EA,the pathological scores,W/D ratio and MDA content were significantly increased,and SOD activities and expression of p-p38MAPK and Nrf2 were significantly decreased in group A-EA-SB.Conclusion p38MAPK signaling pathway mediates EA-induced reduction of ALI in rabbits with endotoxic shock,and up-regulated expression of Nrf2 is involved in the mechanism.
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Objective To review the clinical characteristics of idiopathic portal hypertension (IPH).Methods The clinical and pathological data of 10 patients with idiopathic portal hypertension admitted from December 2008 to December 2014 were retrospectively analyzed.Results Among 10 patients 5 were males and 5 females with averaged age of (38.6 ± 16.1) years.There were splenomegaly and esophageal varices in all 10 cases,upper gastrointestinal bleeding in 3 cases,thrombocytopenia in 9 cases and anemia in 6 cases.Liver function was normal in 7 cases,mild abnormality in 3 cases.Ten cases underwent ultrasound examination and 7 cases had CT scan,cirrhosis was suggested with ultrasound/CT scan in 6 cases.Liver histology showed lobular architecture in existence,no false flocculus to form,variable degree of portal fibrosis appeared.Eight cases were misdiagnosed as liver cirrhosis,the duration of misdiagnosis varied from 1 month to 15 years.Conclusions The clinical manifestation of IPH is similar as cirrhosis caused portal hypertension.Liver histopathological examination can exclude liver cirrhosis,and portal fibrosis and liver terminal portal branch occlusion in histopathology is helpful to the diagnosis of IPH.
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AIM:To explore the safety of anesthesia for neonates by studying the effects of general anesthesia (GA) and spinal-epidural anesthesia (SA) on the levels of lactic acid, S100B, superoxide dismutase (SOD) and malond-ialdehyde ( MDA) in the umbilical cord blood and placental stereological changes .METHODS:The singleton , term preg-nancy of 50 patients for elective cesarean section were assigned to 2 groups:GA group and SA group , with 25 patients in each group.Blood pressure (BP) and heart rate (HR) of the parturient women were monitored and recorded at 6 time points.The Apgar score was calculated at 1 min and 5 min after birth.The gas analysis of the umbilical artery blood , S100B protein concentration, blood lactic acid, SOD and MDA were also measured .Stereological evaluation of the vascular adaptations in the human placental villous capillary was performed .RESULTS:BP, HR, Apgar scores, gas analysis, the pH value of the umbilical artery blood , the serum concentrations of S 100B protein and the length density of villous capillar-ies had no significant change between the 2 groups (P>0.05).The levels of blood lactic acid and SOD in GA group were significantly lower than those in SA group (P<0.01).MDA content and volume density of villous capillaries in GA group were significantly higher than those in SA group ( P<0.01 ) .CONCLUSION: General anesthesia for cesarean section was safety for neonates .However, as indicated by the oxidation index , general anesthesia may have some harmful effect on the neonates by oxygen free radicals .
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Objective To compare the effects of resuscitation at pure oxygen environment(100% oxygen) or room air environment (21% oxygen) on the uhrastructure of cerebral cortical neurons in hypoxic neonatal rat.Methods Twenty Sprague-Dawley neonatal rats aged 7 days were divided into the pure oxygen environment (POE) and room air environment groups (RAE) after hypoxia,and each group was divided again into 24 h and 72 h subgroups.The pups were placed in an incubator containing 8% O_2 to be at acute hypoxia continued for 2.5 h.The pups were reoxygenated immediately after the above mentioned hypoxia.The pups of POE group were then placed in an incubator containing 100% oxygen and the flow time was 30 rain.The pups of RAE group were reoxygenated with room air in an incubator for 30 rain.According to the planned time points the pups were sacrificed and the brain was removed at 24 h and 72 h after treatment,respectively.The tissue of frontoparietal cortex of the fight cerebral hemisphere was prepared for transmission electron microscopic examination.Results In each reoxygenation group,edema was found in the neurons,neuropil and intercellular space.In the RAE 24 h group,the nuclear membrane in neurons was unclear,the amount of cell organelles was reduced,the mitochondria were swollen with damages of cristae.The rough endoplasmic reticulum was dilatated or vaeuolized and with reduction of ribosomes.The Golgi complex was vacuolized.The number of lysosomes was obviously increased.In the RAE 72 h groups,the changes were similar to those of the former group,but apoptotic-like nuclei and necrotic neurons were more frequently seen. The cellular damages of POE 24 h group were milder than those of RAE 24 h group. The mitochondria and rough endoplasmie reticulum were more abundant and showed less pathological changes in the POE 72 h group as compared with those of RAE 72 h group. Conclusion The rats of POE reoxygenation display milder ultrastructural damages, less apoptosis, necrosis and edema in cerebral neurons than those in rats after RAE reoxygenation.The protective effect of POE resuscitation on cerebral damage of hypoxic neonate rats is superior to that after RAE resuscitation. This hypoxic neonatal rat model may serve as a suitable animal model for research on cerebral cortex neurons caused by hypoxia.
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AIM: To evaluate the safety and efficacy of oral oxycodone /acetaminophen or tramadol in early postoperative patients undergoing laparoscopic gynecological operations. METHODS: 120 gynecologic patients receiving laparoscopy operation were enrolled in a randomized,double blind, placebo controlled, multi center clinical trial with early oral analgesics if the vasual analgesia scores (VAS) was scored higher than 3.0. All patients were randomly received a single dose of oral analgesic: oxycodone/acetaminophen, tramadol or placebo, respectively. For rescue medication, PCA pump was provided in all three groups with a dose of 1 mg morphine and lockout of 5 minutes. The VAS scores, pain relief, PCA morphine consumption and side effects were evaluated at the following occasions of 0.25 , 0.5 , 0.75 , 1, 2, 4, 6, 8, 12 and 24 h throughout the study. RESULTS: The VAS scores and pain relief were significantly different in three groups at 0.75 , 1, 2, 4, 6, 8 and 12 h. The VAS scores and PCA morphine consumption was significantly lower in oxycodone/acetaminophen and tramadol groups than those in placebo group. Pain relief in oxycodone/acetaminophen and tramadol groups was better than those in placebo group. The incidence of side effects such as nausea and vomiting significantly increased in tramadol group at 24 h compared with those in the other two groups. CONCLUSION: Early oral administration of oxycodone /acetaminophen or tramadol can provide surgical patients with good and safe postoperative analgesia after laparoscopy gynecologic operation. The incidence of side effects in oxycodone /acetaminophen group is lower than that in tramadol group in this clinical trial.