Objective To develop the severity score of pediatric hand foot and mouth disease (HFMD),guide health care providers in the early detection and intervention of critical ill cases,in order to improve the survival rate and reduce the incidence of complications and mortality.Methods Based on PCIS,the severity score of HFMD in children was designed by adding fever and nervous system damage symptoms,which was the common symptoms of severe cases.The data of the cases who admitted in April 2008 to November 2010 (group A,88 cases) was retrospectively analyzed to evaluate the validity and credibility of the score.The score were prospectively applied to all of the HFMD cases who admitted from May 2011 to October 2013(group B,118 cases),delivering corresponding treatment and care measures based on scoring result as well.At last the outcome of the two groups was compared.Results It exhibited quite good consistency between the scores and the clinical condition of patients with HFMD.The general information of two groups was not significantly different,but the survival rate,the incidence of neurological sequel and the mortality between two groups were significantly different by x2 test.Conclusions The score can objectively and accurately assess the severity of HFMD in children.Clinical application of this scoring method to assess the children with HFMD can identify critical ill cases as early as possible.Corresponding intervention delivering in time may improve the outcome.It is proved to have positive clinical value to increase the survival rate,decrease the incidence of neurological sequel and the mortality of critical ill HFMD cases,and is worthy of clinical application in pediatric department.

Objective To investigate the role of endoplasmic reticulum stress ( ERS) in human brain gliomas cell(SHG-44) apoptosis induced by proteasome inhibitor MG-132. Methods Human glioma cells were passage cultured. Glioma cells were treated by MG-132 with varying concentration(5, 10, 15 and 50 μmol/L) for 24 h. Compared with cells prior to the treatment (control group), cell viability was detected by MTT assay and the expression of ERS associated proteins GRP78 and apoptosis associated proteins Caspsse-12 was examined by PCR and Western-blotting. Results After MG-132 treatment for 24 h, SHG-44 cell viability was decreased significantly (39 %) (P <0.05), and continued to show a significant decline with the increasing concentration of MG-132 (P <0.05). RT-PCR results showed that the expression of ERS associated proteins GRP78 in SHG-44 cells were significantly increased after 5, 10, 15 and 50 μmol/L MG-132 treatment, and the expression of Caspase-12 was significantly increased after 5 μmol/L MG-132 treatment, slightly increased after 10 and 15 μmol/L treatment compared with that after 5 μmol/L treatment and reached the peak after 50 μmol/L treatment. Western-blotting results of GRP78 in SHG-44 cells were same as results of RT-PCR. Conclusion ERS may be involved in the apoptosis of gliomas cells induced by proteasome inhibitor MG-132.

Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and ischemic stroke etiological subtypes, as well as the extent and distribution of cerebral atherosclerosis ( AS) lesions.Methods Patients with ischemic stroke included 285 cases of large-artery atherosclerosis (LAA), 91 cases of small-artery occlusion (SAO) and 42 cases of purely AS, and 165 healthy controls were enrolled in this study.The LAA group was respectively divided into 3 subgroups according to the number and the distribution of stenostic vessels.Genotyping of three single nucleotide polymorphisms (SNPs;rs2073617, rs3134069, and rs3102735) in the promoter region of the OPG gene was performed by polymerase chain reaction-restriction fragment length polymorphism.Results Regarding the three SNPs of OPG gene, the frequence of genotype CC/CT and the prevalence of allele C of rs3102735 were higher in the LAA group contrasting with the control group ( 24.04% vs 14.85%, 44.21% vs 27.88%,χ2 =10.758, 11.804, P =0.001,0.024).However, comparisons of other frequences of genotypes or alleles did not reveal any significant differences among the LAA group, the SAO group, the AS group and the control group, as well as among different subgroups of LAA group.Haplotype analysis revealed that the frequencies of haplotype C-C-T in LAA group and SAO group were significantly lower ( 0.023, 0.017 vs 0.068,χ2 =10.399, 5.841,P=0.001, 0.016), while that of haplotype T-A-C was significantly higher in SAO group(0.043 vs 0.016,χ2 =4.708, P=0.030) compared with controls.Conclusions Our findings indicate that OPG gene polymorphisms might be associated with increased susceptibility to LAA ischemic stroke.But we fail to show association of OPG gene with the extent and distribution of AS.

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.

Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.

To understand epidemiological characteristics of Marek's disease virus (MDV) prevalent in china currently,3 Marek's disease (MD) strains were isolated and identified from white feather meat chickens vaccined with MDV CVI988 or 814 through necropsy,histopathological observation,virus isolation and IFA detection,named SDAU1501,SDAU1502 and SDAU1503,respectively.vIL8,pp38,MEQ gene of the three strains of MDV were amplified using PCR,and compared with reference strains.The homology between SDAU1501 and SDAU1502 and virulent strains was above 97％,suggesting some features of virulent strains;while meq gene of SDAU1503 lost P amino acid at the 194 th site as that in CVI988,But the distinctive 177 nucleotide insertion mutations was not existed,predicting that it may be a attenuated vaccine strain.New variations of MDV continued and different types of variants emerged,therefore,prevalence and genetic monitoring of MD should be proceeded;meanwhile,more attentions should be given to MDV vaccine development.

Purpose: Cancer stem cells (CSCs) are naturally resistant to chemotherapy, explaining why tumorrelapse frequently occurs after initial regression upon administration of chemotherapeuticagents in most cases. A CSC population characterized by CD13 expression has been identifiedin hepatocellular carcinoma (HCC). In the current study, we aimed to clarify the molecularmechanism by which it escapes conventional therapies. Materials and Methods: Here, we used flow cytometry to examine the percentage of CD13+ CSCs in HepG2 andHuH7 cells after chemotherapy. Using in vitro isotope labeling technique, we comparedmetabolic pathways between CD13+ and CD13– subpopulations. Using co-immunoprecipitationand western blotting, we determined the target expressions in protein levels underdifferent conditions. We also performed immunohistochemistry to detect the target proteinsunder different conditions. Animal models were constructed to verify the potential role oftyrosine metabolism in post-chemotherapeutic relapse in vivo. Results: We observed that quiescent CD13+ CSCs are enriched after chemotherapy in HCCs, andserve as a reservoir for recurrence. Mechanistically, CD13+ CSCs were dependent on aerobicmetabolism of tyrosine rather than glucose as energy source. Tyrosine metabolism alsogenerated nuclear acetyl-CoA to acetylate and stabilize Foxd3, thereby allowing CD13+ CSCscells to sustain quiescence and resistance to chemotherapeutic agents. Conclusion These findings encourage further exploration of eliminating CD13+ cells by targeting specificmetabolic pathways to prevent recurrence in HCCs.

OBJECTIVE: To investigate the expression of galectin-1 with the stimulation of peritoneal dialysis solution (PDS) and its role in the epithelial-to-mesenchymal transition (EMT) in human peritoneal mesothelial cells (HPMCs). METHODS: HPMCs were stimulated with PDS containing different concentrations of high glucose (1.5%, 2.5%, and 4.25%). After 24 h, mRNA and protein expressions of galectin-1,vimentin, and zo-1 were analyzed with real-time PCR and Western blot, respectively. Liposome transfected siRNA technique was used to knock down the expression of galectin-1 and the effect of galectin-1 siRNA on the EMT of HPMCs was also observed under 4.25% PDS condition. RESULTS: mRNA expression of galectin-1 in HPMCs increased in PDS groups, especially in group with 4.25% PDS (P<0.05). Protein expression of galectin-1 in HPMCs significantly increased in PDS groups with a dose dependent manner (P<0.05).Expression of vimentin in HPMCs significantly increased in PDS groups, especially in groups of 2.5% PDS and 4.25% PDS (P<0.05), but zo-1 expression markedly decreased (P<0.05). The expression of galectin-1 correlated positively with vimentin (P<0.05) but negatively with zo-1 (P<0.05). Expression of vimentin in groups of 4.25% PDS was markedly inhibited (P<0.05) by galectin-1 siRNA, whereas zo-1 expression was significantly increased (P<0.05). CONCLUSION Galectin-1 can mediate high glucose PDS-induced EMT in HPMCs and may be a new target for the prevention and treatment of peritoneal fibrosis.
Cells, Cultured ; Dialysis Solutions ; pharmacology ; Epithelial Cells ; cytology ; Epithelial-Mesenchymal Transition ; drug effects ; Galectin 1 ; genetics ; metabolism ; Glucose ; pharmacology ; Humans ; Peritoneal Dialysis ; adverse effects ; Peritoneal Fibrosis ; etiology ; Peritoneum ; cytology ; RNA, Messenger ; genetics ; metabolism

Objective To investigate the antithrombotic function of traditional medicine salvia and aspirin in the myocardial infarction rats. Methods The myocardial infarction animal model was established by ligating left anterior descending coronary artery. The rats were randomly divided into the model group, the aspirin group, the salvia miltiorrhiza group, and the combination therapy group, with 8 rats in each group. The salvia miltiorrhiza group was injected with Danshen freeze-dried powder 17 mg/kg via tail vein injection, aspirin group was given aspirin 10 mg/kg, the combination group was given aspirin 10 mg/kg with the tail vein injected with Danshen freeze-dried powder 17 mg/kg, and the model group was given an equal volume of normal saline with an equal volume of saline injected into the tail vein. Continuous administration last 10 days, once daily. The blood coagulation, platelet aggregation, thromboxane B2, 6-Keto-F1α and von Willebrand factor were detected and compared. Results Compared with the model group, the maximum platelet aggregation rate(32.55％ ± 9.57 ％, 32.16％ ± 10.76％, 19.74％ ± 6.70％ vs. 58.75％ ± 4.81％) in the rats of the aspirin group, the salvia group and the combined treatment group significantly decreased, and the contents of TXB2 (70.58 ± 9.31 ng/ml, 73.10 ± 11.33 ng/ml, 49.25 ± 5.33 ng/ml vs. 107.86 ± 17.45 ng/ml) decreased (P<0.01). The maximum platelet aggregation rate and contents of TXB2 in the combination group were lower than those in the aspirin group and the salvia group (P<0.01). Compared with the model group, the 6-Keto-PGF1α content (67.64 ± 7.12 ng/ml, 81.72 ± 10.72 ng/ml vs. 57.80 ± 11.19 ng/ml) of the aspirin group and the combined treatment groupwas increased (P<0.05), prothrombin time (13.11 ± 0.67 s, 15.85 ± 0.25 s vs. 10.77 ± 0.46 s) prolonged (P<0.05), vWF (51.31 ± 4.12 ng/ml, 47.72 ± 10.32 ng/ml vs. 128.81 ± 11.14 ng/ml) decreased (P<0.05). The contents of 6-Keto-PGF1α of the combined treatment group was increased compared with aspirin group and salvia group (P<0.05), prothrombin time decreased than aspirin group (P<0.05) and Salvia group and vWF decreased than Salvia group (P<0.05). Conclusions The salvia miltiorrhiza and aspirin combination therapy has synergistic effect on anti-platelet aggregation and anticoagulant effect. The salvia miltiorrhiza and aspirin combination therapy showed small bleeding risk.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.