Objective To investigate the relationship between the relevant platelet parameters and the thromboelastographic in-dexes with the the occurrence and development of diabetic vascular complications so as to early find the high-risk group of vascular complications or early patients .Methods According to the WHO diagnostic criteria for diabetes ,268 patients with diabetes and 80 retired people with the physical examination (normal control group) were selected as the research subjects .268 cases were divided into the group A(HbA1c <6 .2% without vascular complications) the group B(HbA1c >6 .5% without vascular complications) and the group C(HbA1c >8 .0% with vascular complications ) .The Siemens ADVIA2120 fully automatic blood analyzer was adopt-ed to detect the platelet parameters of mean platelet volume (MPV) ,platelet distribution width(PDW) ,large-platelet(L-PLT) , MPM and mean platelet concentration(MPC);The TEG@ 5000 coagulation analyzer was adopted to perform the thromboelastogra-phy for detecting the values of R ,K ,Angle A and MA .All obtained data were statistically analyzed .Results L-PLT in the group B and the platelet parameters in the group C had statistical differences compared with the normal control group (P<0 .05) .The val-ues of R ,K ,Angle A in the group B and the values of R ,K ,Angle A and Ma in the group C had statistical differences compared with the normal control group (P<0 .05) .Conclusion Relevant platelet parameters and the thrombelastogram detection have the important significance to help to the clinical diagnosis of diabetic angiopathy ,guide the treatment and the condition monitoring ;the thrombelastogram is more sensitive than the detection of the relevant platelet parameters in early finding the patients with diabetic angiopathy .

ObjectiveTo evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.MethodsFifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.ResultsThere were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b)level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45)g/L at week 0 and ( 34.82±4.50)g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.

OBJECTIVE: To explore the genetic basis for a child with infantile liver failure syndrome type 2 (ILFS type 2). METHODS: Clinical features of the child were analyzed. Next generation sequencing was also carried out for him. RESULTS: The child was found to harbor compound heterozygous variants of the NBAS gene, which included a novel nonsense c.2746A>T (p.R916X, 1456) variant in exon 24 and a missense c.3596G>A (p.C1199Y) mutation in exon 31, which has been associated with ILFS type 2. The two variants were respectively inherited from his father and mother. CONCLUSION The compound heterozygous variants of c.3596G>A and c.2746A>T of the NBAS gene probably underlay the ILFS type 2 in this child.
Child ; Exons/genetics* ; Genetic Testing ; High-Throughput Nucleotide Sequencing ; Humans ; Liver Failure ; Male ; Mutation

Objective:To investigate the etiology, prognosis and prognostic factors of pediatric acute liver failure(PALF), in order to provide the basis for clinical treatment of PALF.Methods:The clinical data of children with PALF hospitalized at Hunan Children′s Hospital from May 2008 to May 2018 were collected, and the causes and prognosis were analyzed.According to the prognosis, the patients were divided into the death group and the survival group, whose biochemical indexes were then compared.After that, the statistical analysis of different data were carried out by using t-test, Wilcoxon test and χ2 test separately. Results:In 120 PALF cases, there were 68 males and 52 females, and there were 36 infants, 34 toddlers, 22 preschoolers and 28 school-age children.Twenty cases (16.7%) were caused by sepsis, 19 cases (15.8%) by genetic metabolic diseases, 18 cases (15.0%) by poisoning, 12 cases (10.0%) by viral infection, 6 cases (5.0%) by drugs, 1 case (0.8%) by bile polyp, and 1 case (0.8%) by tumor disease.Besides, the etiology of 43 cases (35.9%) was unknown.Among the cases with known etiologies, genetic metabolic and infectious diseases were the main cause of disease in infants, toddler patients were mostly caused by infectious diseases and drug/toxicants, and drug/toxicants and hereditary metabolic diseases were the dominant cause of disease in school-age children and preschoolers.Mortality rate of children with PALF was 50.0%.Among them, the mortality of Epstein-Barr virus-associated hemophagocytic syndrome, sepsis, Citrin deficiency and Tyrosinemia was higher than that of other diseases.Compared with the survival group, the total bilirubin (TB)[159.00(73.05, 274.00) μmol/L vs.62.75(2.65, 221.75)μmol/L], direct bilirubin(DB)[83.00(41.43, 160.00) μmol/L vs.38.74(10.98, 128.75) μmol/L], prothrombin time (PT)[39.60(24.93, 62.60) s vs.24.65(21.43, 29.83) s], international standardized ratio (INR)[3.40(2.30, 6.74) vs.2.09(1.85, 2.84)], and blood ammonia (NH 3) levels [109.50(85.25, 149.75) μmol/L vs.80.00(60.25, 102.75) μmol/L] in the death group were significantly increased, and the diffe-rences were statistically significant(all P<0.05); while the levels of albumin[(28.72±5.88) g/L vs.(33.69±4.96) g/L], alanine aminotransferase (ALT) [586.50(223.25, 1 082.00) U/L vs.1 434.00(615.00, 3 334.50) U/L]and aspartate aminotransferase (AST) [827.50(545.00, 2 024.00) U/L vs.1 663.50(821.00, 4 886.75) U/L]in the death group were significantly decreased, and the differences were statistically significant(all P<0.05). However, the blood glucose and cholesterol levels in both groups had no statistically significant difference. Conclusion:The mortality of children with PALF is high, and different age groups have different etiologies.The increase of TB, DB, PT, INR, NH3 and the ratio of hepatic encephalopathy, and the decrease of albumin, AST and ALT suggest poor prognosis.

Objective To analyze the clinical characteristics,drug resistance and risk factors for poor prognosis in children patients with carbapenem resistant Klebsiella pneumoniae(CRKP)infection.Methods The samples of CRKP isolated from the children inpatients in this hospital from August 5,2016 to December 31,2020 were collected.The clinical data and drug resistance of CRKP in the patients with CRKP positive were analyzed.The risk factors in the poor prognosis group and good prognosis group of children pa-tients with CRKP infection conducted the correlation analysis.Results A total of 106 strains of non-repeti-tive CRKP were collected,which were mainly isolated from the patients ≤ 1 year old.The department distri-bution was dominated by the neonatal ICU and comprehensive ICU.CRKP showed the high resistance to mul-tiple antibacterial drugs,and its resistance rates to amikacin,levofloxacin,gentamicin,ciprofloxacin,minocy-cline and chloramphenicol were less than 30％.The poor prognosis rate in the children patients with CRKP in-fection reached 27.4％.The logistic multivariate regression analysis results showed that the multiple organ dysfunction and anemia were the independent risk factors for poor prognosis in the children patients with CRKP infection(P＜0.05).Conclusion The children CRKP infection is mainly the infants ≤1 years old,and CRKP shows the high resistance to multiple antibacterial drugs,the independent risk factors of poor prognosis include the multiple organ dysfunction and anemia

OBJECTIVE: To explore the mechanism of ubiquitin-proteasome pathway(UPP) in the degradation of hyperphosphorylated tau protein in aluminum-induced mouse neuroblastoma N2 a cells. METHODS: N2 a cells in logarithmic growth period were randomly divided into control group and MG132 group. Cells in control group were exposed to concentrations of 0 or 1 mmol/L aluminum chloride for 24 hours. Cells in MG132 group were pretreated with MG132 at a concentration of 5 μmol/L for 6 hours, then exposed to concentrations of 0 or 1 mmol/L aluminum chloride for 24 hours. After exposure, the cells were collected. Western blotting was used to detect the relative expression of tau-5, P-tau181, P-tau231, P-tau262, P-tau396, heat shock protein 70(Hsp70) and carboxyl terminus of the Hsp70-interacting protein(CHIP). The ubiquitin relative expression was detected by enzyme-linked immunosorbent assay. RESULTS: The results of factorial analysis showed that the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells were statistically significant in the main effect and interaction effect of aluminum chloride and MG132 treatment(P<0.05). Both in the control group and MG132 group, the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells exposed to 1 mmol/L aluminum chloride increased(P<0.05) when compared with the N2 a cells without exposed to aluminum chloride. No matter aluminum chloride exposed or not, the relative expression of tau-5, P-tau231, P-tau262, P-tau396, CHIP, Hsp70 and ubiquitin in N2 a cells of MG132 group was higher than that of control group(P<0.05). CONCLUSION: UPP is involved in the regulation of hyperphosphorylated tau protein by proteasome degradation in aluminum-induced N2 a cells. UPP mainly regulates P-tau231, P-tau262, and P-tau396 sites. CHIP and Hsp70 played an important role in the UPP pathway.

Objective: To observe the effect of curcumin on myocardial mitochondrial related gene (mtATP6), high mobility group box 1(HMGB1) mRNA expression and plasma HMGB1 level in rats with sepsis, and to explore a new strategy for protection of myocardial injury in sepsis. Methods: A rat sepsis model was established by cecal ligation and puncture (CLP). Thirty male Sprague-Dawley rats were randomly (random number) divided into the sham operation group (sham group), sepsis group (CLP group), and curcumin intervention group (Cur group), with 10 rats in each group. Rats in the Cur group were treated with curcumin by intraperitoneal injection at 100 mg/kg, and normal saline was injected into rats in the sham and CLP groups. Five rats were randomly (random number) sacrificed at 6 h and 24 h after modeling. The pathological changes of myocardial tissue were observed under light microscope. The levels of CK and CK-MB in serum were detected. The HMGB1 level in plasma was detected by ELISA. Real-time PCR was used to detect the expression of HMGB1 mRNA and mtATP6 in myocardial tissue. One-way ANOVA were performed in multigroup mean comparison, LSD-t test was used to compare the mean values of two samples, and P<0.05 was considered statistically significant. Results: The pathological score of myocardial tissue in the Cur group was lower than those in the CLP group at 6 h and 24 h (P<0.05). The CK and CK-MB in the Cur group were lower than those in the CLP group at 6 h and 24 h (P<0.05). The levels of HMGB1 in the Cur group were lower than those in the CLP group at 6 h and 24 h (P<0.05). The expression levels of HMGB1 mRNA and mtATP6 in myocardial tissue of the CLP group were lower than those in the sham group at 6 h (P<0.05), while the expression levels of HMGB1 mRNA and mtATP6 in myocardial tissue of the Cur group were higher than those in the CLP group at 6 h, but the difference was not statistically significant (P>0.05). Conclusion Curcumin protects acute myocardial injury by affecting HMGB1 release and translocation down-regulation of extracellular levels and regulation of mtATP6 expression in CLP model rats.

Objective: To investigate the clinical features of children with infectious mononucleosis (IM), to compare the difference of therapeutic effects between general treatment to antiviral therapy for IM. Methods: This prospective study analyzed the clinical data and laboratory test results of 201 cases with IM in our hospital from January 1, 2016 to December 31, 2016. The follow-up period was 6-12 months. The patients were divided into two groups according to the order of admission. The clinical symptoms and laboratory test results of the two groups were observed after hospitalization. Results: Of the total of 201 patients, male to female is 1.72∶1; Age: 8 months to 13 years 6 months (average 4.8±2.8 years), The disease frequently occurred in summer and autumn, accounted for 64.18%.The major clinical manifestations was fever (97.51%), angina (79.10%), enlarged of lymph node(68.66%), eyelid swelling (67.16%), hepatomegaly (53.73%) and splenomegaly (46.77%). There was no statistical difference in duration of fever, improved angina time, lymph nodes(liver, spleen) enlargement recovery time, heterotypic lymphocytes normalization time, lymphocyte function normalization time.There was significant difference in reducing the serum/plasma or total blood EBV-DNA in the short term between antiviral group and general treatment group (P<0.01), but for the long-term reduction of EBV-DNA, there was no significant difference (P>0.05). The low affinity EBV-CA-IgG was converted to high affinity EBV-CA-IgG in 89.41% of patients after 3 months and in 98.68% of patients after 6 months. With the recovery of the disease, the positive rate of EBV-CA-IgM and EBV-EA-IgG decreased. But the positive rate of EBV-NA-IgG increased. Serum/plasma EBV-DNA was completely overcast after 3 months, but after 12 months, the patient’s total blood EBV-DNA positive rate was still 71.11%. Conclusions In general IM patients, there was no significant difference between antiviral therapy and general treatment, so antiviral therapy is not generally recommended. EBV DNA in the whole blood of patients with IM will continue to be positive more than 6-12 months, indicating that to observe changes of IM should not use whole blood samples for EBV DNA testing.