Multiple organ dysfunction syndrome(MODS),a hot topic worldwide,has made rapid progress with nigh mortality.MODS in pediatrics versus MODS in adults are similar but different.Due to special age-related physiological characteristics.It is difficult to carry out randomized controlled clinical study compared with adults.Diagnosis and treatment of pediatric MODS can only be obtained with reference to adult MODS.This study reviews on the epidemiology,clinical scoring system,pathogenesis,clinical features and treatment of MODS in pediatrics.

Difference between transcranial magnetic stimulation and transcranial direct current stimulation in theory, safety, detection of brain function and clinic treatment were reviewed in order to help reasonably select and effectively apply them in clinic.

Objective To investigate the effect of concurrent exercise intervention in metabolic endotoxemia induced by high-fat diet in rats,and further understand the damage of liver mitochondrial ultramicrostructure.Methods Eighteen SD rats with the weight of 100g were randomly divided into 3 groups:group A (standard diet group),group B(high-fat diet group) and group C (treadmill-trained group with high-fat diet).Training (1 hour/d) initiated at the same time as the HF diet was fed.After being raised for 6 weeks,the rats was euthanized and weighed up.Blood samples were taken and the levels of serum lipid were detected.The levels of serum endotoxin were detected by enzyme-linked immunoadsorbent assay.The membrane potentials of isolated mitochondrion were detected by flow cytometry instrument and the morphologic changes in mitochondria in liver were observed by electronic microscopy.Results In group B,the levels of endotoxin increased significantly(2.916 ± 0.761 rs 5.454 ± 1.254,t =-4.236,P ＜ 0.05),and the liver mitochondrial density and membrane potential also increased significantly compared with group A after 6 weeks (4.330 ±0.501 vs 3.507 ±0.532,t =2.759,P ＜0.05;l.660 ±0.202 vs 0.473 ±0.064,t =13.712,P ＜0.05).But there was no markedly different in serum endotoxin between group B and group C (4.972 ± 1.757 vs 5.454 ± 1.254,t =-0.547,P ＞ 0.05).Compared with group B,the liver mitochondrial density of group C decreased significantly (4.330±0.501 vs 3.581 ±0.188,t =3.426,P ＜ 0.05).The mitochondrial ultrastructurctural changes in each group were not obvious.Conclusions The rats fed with high-fat diet for 6 weeks can reach the state of metabolic endotoxemia.The increasing levels of the liver mitochondrial membrane potential caused by metabolic endotoxin may affect the happening and development of other diseases in the future.Concurrent exercise can not decrease the level of endotoxin.It also shows that metabolic disease caused by high-fat diet should be prevented by moderation in eating and drinking.

Objective To explore the effect on radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle. Methods The patients with pre-T3a stage kidney cancer were divided into two groups, 50 patients in traditional surgical group (traditional group) and 52 patients in post-pyelic retrograde free control of renal pedicle group(research group). The surgical duration, hemarrhage volume, local tumor recurrence in one year after operation, and distal metastasis rate had been compared between the two groups. Results One hundred and two patients underwent successful operations and had one year of follow-up as scheduled after being discharged from hospital. The traditional group took (130± 37) min for surgical duration, and had (400 ± 306) ml of hemarrhage volume; and the research group took (99 ± 28) min for surgical duration, and had (280 ± 225) ml of hemarrhage volume,there were significant difference between the two groups (P < 0.05). After one year of follow-up, 2% (1/50) of local recurrence rate and 6%(3/50) of distal metastasis rate occurred in the traditional group,and only 2% (1/52) of local recurrence rate and 4% (2/52) of distal metastasis rate happened in the research group. There were no obvious difference between the two groups. Conclusion The radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle has such features as easy performance, short surgical duration, less hemarrhage, and can lower the surgical risk, achieve satisfactory efficacy and deserve popularization.

Objective Using Mental Practice as a training method to train students grasping skills of minimally invasive surgery(MIS),and analyze the change of mental practice in training grasping skills of MIS.Methods 36 students were randomly divided into mental practice training group (MPTG) ( n =12 ),conventional training group (CTG) ( n=12),control group (CG) ( n=11 ).Under the uniform appraisal standards and conditions,using different training methods to teach the grasping skills of MIS,and analyze the results statistically.Results MPTG' s pre-training test results ( 16.18 ± 5.73 ) and post-training test results (79.47 ± 22.05 ) were significantly different(P ＜ 0.001 ),post-training and two weeks later test results ( 89.32 ± 31.56) displayed no significant difference(P=0.283) ; CTG' s pre-training test results ( 17.47 ±8.33) and post-training test results (57.18± 21.83 ) were significantly different (P ＜ 0.001 ),post-training and two weeks later test results (42.27 ± 24.64)had significant difference(P=0.048) ; CG's pre-training test results ( 18.19 ± 4.74) and post-training test results (38.04 ± 19.13 ) were significantly different(P =0.003 ),post-training and two weeks later test results (23.71 ±15.71 ) had significant difference (P=0.034).Compared with MPTG in pre-training test,CTG (P=0.632) and CG (P =0.464) neither had significant difference,but in the post-training test,CTG (P =0.014) and CG (P ＜0.001 ) both had significant difference compared with MPTG.In the two weeks later test,CTG and CG both (P＜0.001 ) had significant difference compared with MPTG.Conclusion Mental practice training method can improve the pedormance of gasping skills of MIS significantly and better durability,improve the learning curve,easy to implement in teaching,easy to master students,it will be a new method of MIS skills training in the future.

Uncoupling protein 2 (UCP2) is a proton transporter which presents in the mitochondrial inner membrane.Recently studies found that UCP2 plays important roles in regulation of reactive oxygen species production,maintenance of mitochondrial function,as well as inflammation and blood glucose control.These features have important relevance with the pathophysiologic mechanism of sepsis.

OBJECTIVETo investigate the effect of atorvastatin on cardiac remodeling and function after acute myocardial infarction (AMI) in rats and whether this effect is mediated by transforming growth factor-β1 (TGF-β1) signaling pathway.

METHODSAMI was induced by left coronary artery ligation in 64 male Sprague-Dawley rats, and 45 surviving rats were randomized into control group (n=15), low-dose atorvastatin group (10 mg/kg, n=15) and high-dose atorvastatin group (20 mg/kg, n=15). Similar surgical procedure was performed in sham-operated rats (n=15) without coronary ligation. Atorvastatin was given daily by gavage from the first day after AMI. Eight weeks later, the cardiac function, left ventricular weight/body mass index (LVMI), collagen volume fraction (CVF), and the expressions of TGF-β1 and Smad2 were compared between the groups.

RESULTSAMI caused significantly reduced cardiac function, increased LVMI and CVF, and upregulated expressions of TGF-β1 and Smad2 mRNA and proteins in the control group (P<0.05). The cardiac function, LVMI, and CVF were improved by atorvastatin, which also down-regulated the expressions of TGF-β1 and Smad2 (P<0.05), and the effects were more prominent in high-dose atorvastatin group (P<0.05).

CONCLUSIONAtorvastatin can dose-dependently improve cardiac remodeling and function after AMI in rats, which is mediated by regulating the activity of TGF-β1/Smad2 signaling pathway.

Animals ; Atorvastatin Calcium ; Heart ; drug effects ; physiopathology ; Heptanoic Acids ; pharmacology ; Male ; Myocardial Infarction ; physiopathology ; Pyrroles ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Smad2 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Ventricular Remodeling ; drug effects

OBJECTIVETo clone and express VP1-VP4 genes encoding the structural proteins of Coxsackie virus A16 and analyze the antigenicity of the expressed recombinant proteins.

METHODSThe VP1-VP4 cDNAs were amplified with RT-PCR from the extracted viral RNA and cloned into pMD19-T vectors. The VP1-VP4 genes were inserted to the multi-cloning sites of the plasmid pQE30a, and the protein expressions in E. coli M15 were induced by IPTG. After purification by washing with 8 mol/L urea under denaturing condition, the recombinant proteins were identified by Western blotting and ELISA for their immunogenicity against rabbit antisera of Coxsackie virus A16 and enterovirus 71, respectively.

RESULTSThe recombinant VP1-VP4 proteins were highly expressed in E. coli M15. The purified proteins could be recognized by rabbit antiserum of Coxsackie virus A16 and showed cross reactivity with the rabbit antiserum of Enterovirus 71.

CONCLUSIONThe recombinant Coxsackie virus A16 VP1-VP4 proteins obtained possess good antigenicity.

Antigens, Viral ; genetics ; immunology ; Capsid Proteins ; classification ; genetics ; immunology ; Cloning, Molecular ; Enterovirus A, Human ; genetics ; Gene Expression ; Genetic Vectors ; Plasmids ; Recombinant Proteins ; genetics ; immunology ; Reverse Transcriptase Polymerase Chain Reaction

Objective To investigate the therapeutic effects of haploidentical hematopoietic stem-cell transplantation (Haplo-PBSCT) for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy. Methods Eighty-nine cases of AML in first relapse after complete remission by standard DA/Hi-Ara-C regimens induction chemotherapy were evaluated retrospectively. Fiftythree cases were grafted by haplo-PBSCT and 26 cases were treated with iDA/Mid-Ara-C or MA/ Mid- Ara-C agents. Results The second remission rate in haplo-PBSCT group and continuous chemotherapy group was 86. 7 % (46/53 cases) and 38. 1% (9/23 cases) respectively (P＜0. 01). Survival postprogression (SPP) at 36th month was 43. 4 % (23/53 cases) in haplo-PBSCT group and 11.5 % (3/26 cases) in continuous chemotherapy group (P ＜ 0. 05). Conclusion Haplo-PBSCT could significantly increase the second remission rate and prolong the survival time of patients with acute myeloid leukernia in first relapse after complete remission by standard induction chemotherapy.

Objective:To study the expression and value of inflammatory factors and disease activity in dry eyes of rheumatoid arthritis patients.Methods:From March 2017 to November 2019, 78 patients with rheumatoid arthritis complicated with dry eye diagnosed by the rheumatology department of our hospital, 80 patients with simple dry eye treated in the ophthalmology clinic and 80 normal volunteers were collected. All subjects were examined for OSDI questionnaire scores, tear film rupture time (BUT), tear secretion test (SIT), and corneal fluorescein staining (FL) scores. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and other disease activity-related indicators were collected. The concentrations of interleukin-1b (il-1b), tumor necrosis factor-a (tnf-a), chemokine 3(CCL3), CCL4, CCL5, and vascular endothelial growth factor (VEGF) in the collected tears were detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). One-way Anova was used to analyze the correlative indexes among the three groups, LSD- t method was used for multiple comparison. Pearson's method was used to analyze the correlation between Ra activity and dry eye. Results:The results of OSDI [(44±9) points vs (44±9) points vs (24±7) points], SIT [(3.3±2.2) mm/5 min vs (3.6±2.1) mm/5 min vs (11.7±1.6) mm/5 min], BUT [(4.3±1.8) s vs (5.9±1.9) s vs (10.4±2.0) s], FL [(7.3±3.1) points vs (5.7±2.8) points vs (1.6±1.6) points] were com-pared among the three groups. There were significant differences among the three groups( F=154.22, P<0.01; F=470.49, P<0.01; F=217.72, P<0.01; F=101.99, P<0.01). The concentrations of IL-1β [(1.92±0.14) ng/L vs (1.28±0.18) ng/L vs (0.64±0.15) ng/L], IL-6 [(38.24±0.69) ng/L vs (36.31±0.82) ng/L vs (30.43±0.87) ng/L]、TNF-α [(0.78±0.03) ng/L vs (0.67±0.03) ng/L vs (0.56±0.02) ng/L], CCL3 [(91±25) ng/L vs (83±21) ng/L vs (24±18) ng/L], CCL4 [(187±76) ng/L vs (137±64) ng/L vs (37±5) ng/L], CCL5[(259±70) ng/L vs (182±42) ng/L vs (135±34) ng/L] and VEGF [(172±25) ng/L vs (152±22) ng/L vs (41±21) ng/L] in the tears of the three groups were significantly different( F=1 300.15, P<0.01; F=2 036.37, P<0.01; F=1 305.89, P<0.01; F=764.01, P<0.01; F=225.47, P<0.01; F=138.48, P<0.01; F=121.04, P<0.01). The indexes of disease activity (ESR, CRP, RF) were compared among the three groups. The positive rate of RF[(100%) vs (5%) vs (4%)] was significantly higher in Ra dry eye group than in the other two groups ( χ2=127.38, P<0.01) There were significant differences in ESR[(51±23) mm/1 h vs (9±4) mm/1 h vs (8±5) mm/1 h] and CRP[(44±23) g/L vs (5±4) g/L vs (6±4) g/L] among the three groups ( F=253.18, P<0.01; F=222.36, P<0.01) . BUT was negatively correlated with the activity index (ESR, CRP, RF) in rheumatoid arthritis dry eye group ( r=-0.398, P=0.005; r=-0.353, P=0.010; r=-0.302, P=0.038) , FL was positively correlated with activity index (ESR, CRP, RF) ( r=0.345, P=0.014; r=0.385, P=0.007; r=0.412, P=0.003) . There was no correlation between SIT, OSDI and activity index (ESR, CRP, RF)( r=-0.265, P=0.060; r=-0.156, P=0.318; r=-0.275, P=0.070); ( r=-0.087, P=0.582、 r=-0.065, P=0.664; r=-0.045, P=0.768). Conclusion:Inflammatory factors and disease activity indexes are highly expressed in rheumatoid arthritis patients with dry eye of disease, and there is a correlation between disease activity of rheumatoid arthritis and dry eye, which has some clinical meaing.