BACKGROUND:microRNA-17 is confirmed to play an important role in the development of pulmonary hypertension. Some research has shown that hypoxia-induced proliferation in human pulmonary artery smooth muscle celldepends on the induction of arginase II. There is no report about whether there is some interaction between microRNA-17 and arginase II in human pulmonary artery smooth muscle cells.
OBJECTIVE:To investigate the possible interactions between microRNA-17 and arginase II in hypoxic human pulmonary artery smooth muscle cells.
METHODS:Passage 4 human pulmonary artery smooth muscle cells were cultured in 21%O 2 and 5%CO 2 (normoxia) or 1%O 2 and 5%CO 2 (hypoxia), and then transfected with mimic or inhibitor of microRNA-17 or arginase II-smal interfering RNA. RNA, microRNA and protein were isolated separately. Expression of microRNA-17 and arginase II was detected with real-time quantitative PCR and western blot assay. RESULTS AND CONCLUSION:The level of microRNA-17 was significantly increased in cultured human pulmonary artery smooth muscle cells exposed to 1%O 2 hypoxia, as was arginase II mRNA and protein expression. Furthermore, inhibition of microRNA-17 expression decreased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under hypoxia. Conversely, over-expression of microRNA-17 increased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under normoxia and hypoxia. Knockdown of arginase II by siRNA abolished the hypoxia-induced up-regulation of microRNA-17 expression. These findings indicate that arginase II is a target gene of microRNA-17 and can regulate the expression of microRNA-17 in human pulmonary artery smooth muscle cells.

Objective To investigate the expression ofTNF- α mRNA and cytokeratin 20(CK20)mRNA in different tissue of colonic cancer patients, and the relations between the expression and the classify,invasion, as well as Dukes stage of colonic cancer. Methods RT-PCR method was used to detect the ex-pression of TNF-α mRNA and CK20 mRNA in 30 cases of colonic cancer, included cancer tissue,para-cancer tissue and normal tissue. Results The positive rate of TNF- α mRNA expressions in cancer tissue, para-cancer tissue and normal tissue were 70.0%, 43.3% and 20.0%, and the positive rate of CK20mRNA expressions were 63.3%, 33.3% and 16.7%, there were significant difference among the three tissues(P ＜ 0.01 ). But the expression of CK20 mRNA in para-cancer tissue had no significant difference compared with normal tissue (P＞ 0.05). The expression ofTNF- α mRNA was closely correlated with that of CK20mRNA.TNF- α mRNA and CK20 mRNA showed no significant difference in expressing of colonic cancer tissue (P ＞ 0.05 ), but TNF- α was closely correlated with Duke stage and depth of tumor invasion (P ＜ 0.05 ).Conclusion The expression of TNF- α mRNA is objective indicator associated with the invasion of the colonic cancer.

Objective To summarize our experience in diagnosis and treatment of splenic tumors.Methods A retrospective study of the clinicopathologic data of 92 cases of splenic tumor was performed.Results There were 47 benign and 45 malignant tumors.The preoperative confirmed diagnostic rate by B-US was 85.87%(79/92),by CT was 91.30%(84/92).Splenectomy was performed in 81 cases,tumor resection or partial splenectomy in 7 cases,needle aspiration of splenic cyst in 3 cases and biopsy in one case.The 1-,3-,5-,10-year survival rate of malignant tumor was 68.29%,31.70%,14.63%,0.24%,respectirely.Conclusions Imaging studies are the main diagnostic methods of splenic tumors.Splenectomy is the treatment of choice for primary splenic malignant tumor.Splenic benign tumor does not require any other therapy after operation.Splenic malignant tumor requires adjuvant treatment.

Objective To observe the complications in children after percutaneeus closure of atrial septal defect (ASD). Methods 192 children,who successfully received percutaneous closure of ASD in our hospital were enrolled in this study. Diameter of ASD was 8.0 ～ 33.0( 16.7± 8.0) mm, the diameter of occluder was 8.0 ～ 38.0 ( 18.9 ± 8.2) mm. The follow-up term ranges from 1 month to 4 years, with a mean of 19.0 ± 4.5 months. Standard 12-lead electrocardiography (ECG) and transthoracic echocardiography (TIE) were performed before closure, 24 including: minimal-moderate residual shunt in 3 patients ( 1.6% ), atrial-ventricle block (AVB) in 1 ( 0.5 % ), sinus There were 184 cases of single-hole ASD, with complication rate of 2.7% (5/184) , including the complication rate in diameter of siagle-hole ASD less than 10mm was 0% , that in ASD between 10 mm and 20 mm was 1.7% (2/119) ,that in ASD more than 20 mm was 5.0% (3/60) ,while there were 8 cases of two- and multi-hole ASD, clusion, including 3 cases of minimal-moderate residual shunt, 1 case of atrial-ventricle block, 1 case of sinus brady-cardia, and 1 case of device-micro-malplesition. 2 days to 2 weeks after procedure, 1 case developed pelade ( 1/192 ). completely recovered (57. 1% ), including 1 case of residul shunt, 1 case of atrial-ventricle block, sinus bradycardia and 1 case of pelade. 2 cases of minimal residual and 1 case of device-micro-malposition were not recov-ered. Conclusions Transeatheter closure of ASD is safe and effective with few complications, most of which disapp-eare completely during follow up term. Long-term follow-up is needed to evaluate the progress of some rare complica-tions.

Objective:To investigate the effect of different postoperative nutritional support on the gastrointestinal function and nutritional status in acute colon peforation patients.Methods:60 cases of acute emergency operation patients with perforation of the colon,according to the given nutritional support treatment of the different ways,were divided into enteral parenteral joint nutrition (EN + PN) group and total parenteral nutrition (TPN) group.Clinical therapeutic effects of two groups were compared.Results:The results of EN + PN group were significantly better than the those in TPN group (P ＜ 0.05).Conclusion:EN + PN model can improve the postoperative nutritional status and accelerate the recovery of patients with acute colonic perforation.

Objective:To understand the status of sedation and analgesia treatment and management in pediatric intensive care unit(PICU) in Shandong Province, and to provide the basis for the improvement of sedation and analgesia treatment plan.Methods:This study was a multi-center retrospective study.The PICUs of 6 tertiary hospitals in Shandong Province participated in this study.The data of 1 340 children admitted to these 6 PICUs from January 2016 to December 2018 were collected.The age, gender, the pediatric risk of mortality score Ⅲ at 24 hours after admission, whether they received mechanical ventilation, whether they received sedation and(or) analgesia, whether they were monitored sedation and(or) analgesia, and in-hospital mortality were analyzed.The children were divided into the simple sedation group( n=798), the sedation + analgesia group( n=120) and the non-sedation analgesia group( n=422) according to whether they received sedation and(or) analgesia.The diseases, proportion of mechanical ventilation, incidence of hypotension, average length of stay in PICU and in-hospital mortality were compared among the three groups. Results:The median age of the 1 340 children was (13.3±6.4) months, including 786 males(58.7%). Sedation therapy had been carried out in 6 PICUs, of which 5 PICUs had routine sedation assessment; 4 PICUs had carried out analgesic therapy, of which only 2 had routine pain assessment.A total of 918 children(68.5%)received sedation and(or) analgesia, midazolam was the most commonly used sedative drug, followed by dexmedetomidine, and 526 children(57.3%)were monitored for sedation assessment, the most commonly used assessment method was the Richmond agitation sedation score.One hundred and twenty(9.0%)cases received sedation combined with analgesia, fentanyl was the most commonly used analgesic, and 38 children(31.7%) underwent routine pain assessment.There was no significant difference in age and sex among the three groups.The proportion of surgical diseases and patients received mechanical ventilation(100.0%, 120/120) were the highest in the sedation + analgesia group.The proportion of mechanically ventilated patients was the lowest in the non-sedation analgesia group(11.4%, 48/422). The mean duration of mechanical ventilation in the sedation + analgesia group was slightly shorter than that in the simple sedation group( P>0.05). The incidence of hypotension was highest in the sedation + analgesia group, and lowest in the non-sedation analgesia group[21.7%(26/120) vs.2.1%(9/422), P<0.01]. There was no significant difference in in-hospital mortality and mean PICU stay among three groups. Conclusion:Benzodiazepines are still the main sedative drugs used in PICUs in Shandong Province.In recent years, the usage of dexmedetomidine has gradually increased, but the proportion of analgesic use is very low.At present, analgesic and sedative therapy is mainly used for children after surgery and receiving mechanical ventilation.Although analgesic and sedative therapy does not increase the in-hospital mortality and average length of stay in PICU, it increases the incidence of hypotension.The sedative and analgesic treatment and assessment in the PICU of Shandong Province are still not standardized, mainly reflected in infrequently analgesic treatment and the assessment of sedation and pain, which need to be further improved.

Objective:Through the establishment and preliminary application of standardized, real-time and online database of severe sepsis in children, we can realize the information about management of children with severe sepsis, providing data to support scientific research and clinical work, and building a homogeneous scientific research and clinical platform for multiple units participating in constructing the database.Methods:We designed, developed and established an online database system for children with severe sepsis, which was filled in in real time by 19 member units of Diagnosis and Treatment Collaboration Group for Sepsis in Children in Shandong Province.The basic information, treatment and prognosis of children entered in the database were preliminarily analyzed.Results:(1)A real-time online disease-specific database for severe sepsis in children was established primarily, with the classification, storage, logical retrieval, statistical analysis and map-making of the information of children with severe sepsis.(2)Further analysis was conducted on the clinical data of 602 children with severe sepsis, which had been recorded in the database.There were 341 males(56.6%)and 261 females(43.4%). The median age was 16 months.There were 230(38.2%)children younger than 1 year old, and 274 children aged from 1 to 5 years old(45.5%), 98 children(16.3%)were 6 years old and above.Three hundred and forty-three cases(57.0%)were from rural areas.One hundred and eighty-one cases(30.1%)were found to have basic diseases.The primary site of infection was the respiratory system(40.8%). The in-hospital mortality was 15.6% in children with severe sepsis.Multivariate Logistic regression analysis showed that high pediatric risk of mortality score Ⅲ score at 24 hours after admission, acute respiratory distress syndrome, acute renal injury, mechanical ventilation and vasoactive drug treatment were independent risk factors for in-hospital death in children with severe sepsis( P<0.05). Conclusion:The disease-specific database of severe sepsis in children can provide data for scientific research and clinical practice of sepsis management in children, and contribute to the formulation and improvement of clinical decision-making in the future.Simultaneously, it has also constructed a homogeneous scientific research and clinical work platform, which may contribute to the common development of the participatory units.

Blood adsorption, one of the blood purification, can be classified into hemoperfusion and immunoadsorption.In recent years, double plasma molecular adsorption, a combined adsorption, has also been widely used in clinical practice.Based on adsorption, the toxins in blood of patients can be efficiently removed by hemoadsorbents.There are two kinds of adsorbents commonly used in hemoperfusion: carbon and resin, and two types of adsorbents in immunoadsorption: biological affinity and physicochemical affinity.Adsorption has been widely applied in clinical practice, involving in sepsis, organ transplantation, systemic lupus erythematosus, liver failure, autoimmune diseases and so on.The review described the application of blood adsorption in clinical practice.

Objective:To investigate the protective effect of baicalein on injured PC12 cell induced by Aβ and explore its mechanism.Methods:The method of MTT was used to detect the cell activity of each group and screened the concentration of baicalein. The PC12 cells were randomly divided into the blank group, the Aβ group, the baicalin group and the estradiol group. 24 hours after inoculation, baicalein group was intervened with 1×10 -6 mol/L baicalein solution, and estradiol group was intervened with 1×10 -5 mol/L estradiol solution. Two hours later, except the blank group, the other groups were added with 1.5×10 -4 mol/L Aβ to make the model. MTT assay was used to detect the cell viability of each group after 24 hours of cultivation. Then used oxidation kit to detect the contents of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and lactate dehydrogenase (LDH) in each group. And the level of caspase-3 mRNA was detected by Real-time Quantitative PCR (RT-PCR). Then the Western blot method was used to detect the expressions of p-PI3K, p-AKT and caspase-3. Results:Compared with the Aβ group, the PC12 cell viability [(96.348 ± 0.571)%, (97.183 ± 0.714)% vs. (86.922 ± 0.429)%] in the baicalin group and the estradiol group significantly increased( P<0.01). The activities of SOD [(54.31 ± 1.34) U/mgprot, (57.38 ± 2.25) U/mgprot vs. (36.18 ± 2.24) U/mgprot] and GSH-PX [(4.46 ± 0.23) U/mgprot, (4.72 ± 0.31) U/mgprot vs. (2.05 ± 0.37) U/mgprot] significantly increased, and the level of LDH [(85.43 ± 0.92) nmol/ml, (82.46 ± 0.27) nmol/ml vs. (99.17 ± 0.52) nmol/ml] significantly decreased ( P<0.01). The expression of caspase-3 mRNA (2.24 ± 0.64, 2.33 ± 0.75 vs. 3.46 ± 0.46) and p-PI3K (0.46 ± 0.03, 0.44 ± 0.06 vs. 0.66 ± 0.09), p-AKT (0.43 ± 0.05, 0.41 ± 0.02 vs. 0.58 ± 0.03), caspase-3 (0.61 ± 0.03, 0.56 ± 0.53 vs. 0.92 ± 0.07) protein significantly decreased ( P<0.01). Conclusion:Baicalein could slow down cell apoptosis and oxidative reaction, reduce the damage of Aβ to PC12 cells by inhibiting the expression of PI3K/AKT pathway.

Fluid overload is frequently found in critically ill patients with pediatric heart failure.Volume management is one of the important therapeutic measures for pediatric patients with heart failure, the aim of which is to achieve the best individual volume homeostasis.Assessment of volume status is the premise and foundation of volume management.The comprehensive evaluation and effective management of volume status leave clinical doctors a great challenge.In order to provide guidance and evidence for clinicians, this review elucidated the methods for assessment and management of volume status for pediatric patients with heart failure.