Objective To explore the conditions, safety and efifcacy of exchange transfusion for extremely severe hyper-bilirubinemia in term newborns requiring mechanical ventilation. Methods Ten full-term newborns of extremely severe hyper-bilirubinemia requiring mechanical ventilation were selected from January 2010 to March 2013 in the department of neonatology. After stable vital sign was achieved by the use of conventional life support, peripheral arterial and venous synchronous exchange transfusion was performed. The bilirubin, platelets, blood calcium, blood coagulation and blood gas were monitored before and after exchange transfusion. The effects and adverse events of exchange transfusion in newborns on mechanical ventilation were observed. Results There was no death in the study, and the replacement rate of total bilirubin was 50.5%. The main adverse event was thrombocytopenia (80%). There was a signiifcant difference in platelet counting before and after exchange transfusion (P<0.05). There was no signiifcant difference in blood coagulation, pH/HCO3-of the blood gas, prothrombin time (PT) and acti-vated partial thromboplastin time (APTT) before and after exchange transfusion. Conclusions It is relatively safe to implement an exchange transfusion in the full-term newborns with severe hyperbilirubinemia in newborns requiring mechanical ventilation, but the use of conventional life support is prerequisite because it stabilizes vital signs. The relatively ideal replacement rate of bili-rubin and the low incidence of adverse reactions are expected. However long-term prognosis of neural system is still unknown.

Objective To investigate the role of oxidative stress in the epithelial-to-mesenchymal transdifferentiation (EMT) of peritoneal mesothelial cells in rat model of peritoneal fibrosis and the effect of probucol on peritoneal fibrosis. Methods The rat model of peritoneal fibrosis was induced by 4.25% high glucose peritoneal dialysis fluid (PDF). The rats were randomly divided into 4 groups:the control group, the saline group, the peritoneal fibrosis group, and the probucol group. A 4 hour peritoneal equilibration test (PET) was performed 4 weeks later. The peritoneal function and net ultrafiltration (UF) volume were determined. The level of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) in peritoneal tissue were examined. The histology of peritoneal membrane was evaluated by light microscopy. E-cadherin and α-smooth muscle actin (α-SMA) protein expression was evaluated by immunohistochemical method and Western blot.Results The mesothelial cells were detached from peritoneal membrane in peritoneal firbosis rats. Comparing with the control rats, the thickness of visceral peritoneum, the level of MDA, and the-SMA protein expression were increased while the net ultrafiltration volume, the level of GSH-Px and E-cadherin protein expression were decreased in peritoneal firbosis rats. All these changes were reversed in the rats treated with probucol.Conclusion Oxidative stress plays an important role in transdifferentiation of peritoneal mesothelial cell in the peritoneal fibrosis rats. Probucol can improve structure and function of peritoneum, and partially reverse the EMT by reducing the oxidative stress.

Objective To evaluate the nephrotoxicity induced by radiographic contrast media with different osmolality in rats with hypercholesterolemia, and to explore the protective effect of pentoxifylline. Methods Forty-eight healthy SD male rats were randomly divided into normal dietary group (NN, n =8) and high cholesterol supplemented dietary group (H, 4% cholesterol and 1% cholic acid, n=40). At the end of 8th week, the rats with high cholesterol diet were randomly divided into five subgroups (n=8, respectively): high cholesterol diet group(HN), high cholesterol plus iso-osmolar contrast media (iodixanol, IOCM) group (HI), high cholesterol plus low-osmolar contrast media (iohexle, LOCM) group (HL), high cholesterol diet plus high-osmolar contrast media (diatrizoate, HOCM) group (HH) and high cholesterol plus HOCM plus pentoxifylline group (HHP). Forty-eight hours after contrast media injection, the rats were executed and blood samples were prepared to determine total cholesterol, triglyceride, serum creatinine, creatinine clearance(Ccr), fractional excretion of sodium and potassium(FeNa, FeK), and angtension Ⅱ (Ang Ⅱ) levels. The renal injury was assessed by HE staining and TUNEL staining, respectively. The expression of NF-κB protein in the renal tissue was detected by using immunohistocbemical method. Results An increase of cholesterol was observed in all the rats with high cholesterol diet. Scr, FeNa%, FeK% and Ang Ⅱ levels of rats in HH group were obviously higher than those in HL and HI groups respectively. Ccr in HH group [(0.11±0.02) ml·min-1·(100 g)-1] was significantly lower than that in HHP group [(0.43±0.03) ml·min-1·(100 g)-1], HL group [(0.25±0.02) ml·min-1·(100 g)-1] or HI group [(0.27±0.03) ml·min-1,(100 g)-1] (P<0.05). TUNEL staining showed that the pewentage of apoptotic cells in HH group [(89.60±6.40)% ] was higher than that of the other groups [NN (2.40±0.77)%, HN (5.60±1.08)%, HHP (8.91±1.44)%, HL (63.34±11.97)% and HI (61.50±9.40)%]. Immunohistochemistry staining showed that the average gray value of NF-κB positive cells in HH group decreased (P<0.05). There were no significant differences of all indices between HL and HI groups (P0.05). Conclusions Contrast media can cause kidney injuries in the rats with hypercholesterolemia. PTX can protect the renal tissue from nephrotoxicity induced by HOCM in hypercholesterolemia.

Objective To explore the role of oxidative stress in the epithelial-tomesenchymal transition (EMT) of tubular epithelial cells and the protective effect of probucol in rat model with diabetic nephropathy (DN). Methods Thirty SD rats were randomly divided into normal control group, DN group, probucol treatment group (supplemented 1% probucol dietary). Twentyfour hours urinary protein excretion (UTP) was measured at the 3rd, the 8th and the 12th week respectively. The biochemical indicators including blood glucose (BG), lipids [triglyceride (TG), total cholesterol (TC)], low-density lipoprotein (LDL), serum creatinine (Scr), creatinine clearance rate (Ccr),kidney tissue malondialdehyde (MDA) level and glutathione peroxidase (GSH-Px) activity were assessed at the end of the 12th week in all groups. The renal pathological changes were evaluated by hematoxylin & eosin (HE) and Masson staining. The protein expression of specificity protein 1 (Sp1), α-smooth muscle actin (α-SMA) and E-cadherin was also detected and analyzed by immunohistochemistry and Western blotting. Results Compared with the normal control group,the BG, TC, LDL, Scr, 24 h UTP and MDA level of renal tissue increased significantly and the Ccr reduced in the rats of DN group (all P＜0.01). The pathological scores and the expression of Sp1 and α-SMA in renal tissue were higher in the DN animals than that in the other animals (all P＜0.01), the expression of E-cadherin downregulated significantly in the DN animals (P＜0.01). The MDA level of renal tissue was positively correlated to the expression of α-SMA and Sp1 protein in DN group (r=0.896, P＜0.01; r=0.862, P＜0.01, respectively), and negatively correlated to the expression of E-cadherin protein (r=-0.673, P＜0.01). In the diabetic animals treated with probucol, the Scr, 24 h UTP, pathological scores, MDA content,expression of Sp1 and α-SMA in renal tissue were lower than those in the diabetic animals (all P＜0.01). The Ccr and the expression of E-cadherin upregulated obviously (all P＜0.01). Conclusion Oxidative stress plays an important role in the EMT process of tubular epithelial cells. Probucol can slow down renal disease progression in DN rats through anti-oxidant, downregulating the expression of Sp1 protein and inhibiting the renal tubular EMT.

BACKGROUND AND OBJECTIVETraditional Chinese medicine is an approach for malignant tumor treatment with Chinese characteristics. The aim of this study is to investigate the inhibitory effects of Maimendong & qianjinweijing decoction extract on A549 human lung cancer cell line proliferation and explored its probable molecular mechanisms.

METHODSA549 cells were treated with drugs in different does and time. The effects on the proliferation of A549 cells were detected by MTT assay and clonogenic assay in vitro. Cell cycle was analyzed by flow cytometry. Morphological changes of the apoptosis of cancer cells were observed by Hochest 33258 staining. Western blot was performed to detect apoptosis-related gene expression.

RESULTSEthyl acetate extract inhibited the growth of A549 cells but not in HFL-1 cells. Compared with controls, administration of 10 microg/mLethyl acetate extract resulted in 73.86% decrease in colony formation (P < 0.01), apoptotic rates of 33.86% (P < 0.01), and morphological changes of apoptosis in A549 cells. The expression of anti-apoptotic protein EGFR and ERK were significantly down-regulated (P < 0.01).

CONCLUSIONEthyl acetate extract might inhibit proliferation and induce apoptosis in A549 cells via downregulation of EGFR/ERK signal transduction pathway. Therefore, ethyl acetate extract should be further separated in order to identify the material fundamentals on anti-cancer effect.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; Humans ; Lung Neoplasms ; drug therapy ; pathology

Objective: To determine the possible relations between hair cortisol concentration (HCC) as a biomarker of chronic stress and childhood overweight and obesity. Methods: Children from grade 1 to 3 from 2 primary schools in Bengbu were invited to participate in the study; and those who suffer from mental disorders, endocrine diseases and those who took hormone drugs were excluded. Parental questionnaire was implemented to collect information on physical activity, screen time, sleep duration, sugar-beverage consumption, as well as socio-economic status. Height and weight were examined. Eligible hair samples from 1 263 children (598 boys and 665 girls) were obtained, and the cortisol content was determined. Multivariate logistic regression model analysis was recruited to examine the association between HCC quartiles and overweight and obesity among boys and girls, respectively. Results: HCC in P₅₀ (P₂₅-P₇₅) among girls and boys was separately 11.86 (10.57-13.15) and 11.71 (10.54-13.09) µg/kg (Z=-0.886, P=0.376); HCC in P₅₀ (P₂₅-P₇₅) among non-overweight, overweight and obesity boys was separately 11.62 (10.45-12.82), 12.24 (10.88-13.55) and 12.30 (10.99-13.53) µg/kg (χ²=8.24, P=0.016); HCC in P₅₀ (P₂₅-P₇₅) among non-overweight, overweight and obesity girls was separately 11.35 (10.06-12.62), 12.07 (11.04-13.21) and 12.59 (11.12-13.63) µg/kg (χ²=36.16, P<0.001). After age, physical activity, screen time, sleep duration, sugared beverages and socio-economic status adjusted, compared with HCC in Q1 level, girls whose HCC in Q2, Q3 Q4 level had higher rates in overweight, with OR (95%CI) at 1.10 (1.04-3.32), 2.59 (1.51-4.45) and 3.16 (1.79-5.57), respectively. Girls with HCC in Q3 and Q4 level had higher rates in obesity, with OR (95%CI) at 2.22 (1.16-4.26) and 5.62 (3.04-10.41). Among boys, highest quartiles in HCC was risk factor for overweight, OR (95%CI) was 2.14 (1.18-3.90). Conclusion Hair cortisol had a significant relation with overweight and obesity in 6-9 years old childhood especially among girls.

Objective Based on Chinese guidelines for the management of ischemic stroke, a standardized stroke management program was performed to provide intensive education and training for medical physicians, aiming to enhance their knowledge and ability for ischemic stroke prevention and treatment, thereby reducing patients′ in-hospital cost and length of stay, and improving patients′ clinical prognosis. Methods This study was conducted in 20 general hospitals throughout Hainan province. A total of 163 physicians from 20 hospitals involved in the management of stroke patients were trained by highly experienced physicians based on the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2014 and the Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack 2014. Prior to and post the standardized stroke management training, the data of 3218 and 3367 patients with ischemic stroke were respectively collected. Quality of life assessments including the Barthel index (BI) and the modified Rankin Scale (mRS) score of all patients were recorded at baseline and after discharge. The length of stay and in-hospital cost were directly collected from the hospital information system. Results Physicians′ knowledge and ability manifested as testing scores were significantly improved after training (78.2 ± 15.5 vs 55.6 ± 10.7, t=69.1, P<0.01). The average length of stay of post-training patients was significantly shorter than that of pre-training patients ((8.7 ± 0.9) vs (11.7 ± 1.5) days, t=97.9, P<0.01). The average in-hospital cost of post-training patients was significantly less than that of pre-training patients ((7681.7 ± 1397.7) vs (11846.2 ± 2514.6) Yuan, t=82.5, P<0.01). Both BI (68.2 ± 3.2 vs 43.5 ± 5.3, t=227.7, P<0.01) and mRS score (2.74±0.51 vs 3.65±0.71, t=59.5, P<0.01) were significantly improved for post-training patients. Multivariate linear regression analysis illustrated that standardized stroke management was negatively associated with in-hospital cost (r=-0.461, P<0.01), length of stay (r=-0.357, P<0.01) and mRS score (r=-0.298, P<0.01), and was positively associated with levels of BI (r=0.376, P<0.01). Conclusion Standardized stroke management program might be a cost-effective choice for the management of ischemic stroke as it reduces the in-hospital cost and improves patients′BI and mRS levels.

Objective: To determine possible relations between early adiposity rebound and adolescent development. Methods: Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 (2010), Cohort 2 (2011) and Cohort 3 (2012) according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera's method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using t test and χ² test. Multivariate regression analysis was applied to explore the association between early adiposity rebound and breast development. Results: The average age of participants was (8.90±0.87) years old and the BMI was (17.48±2.70) kg/m². The average age at adiposity rebound was (6.16±0.90) years old and the BMI was (15.33±1.82) kg/m². Premature breast development was found significantly higher in girls in early adiposity rebound group (27.8%, 54/802) than it in normal adiposity rebound group (13.7%) (P<0.001). After current adiposity, age, household economic status, childhood physical activity adjusted, the OR of premature beast development in early adiposity rebound group was 2.41(95%CI: 1.41-4.12). Conclusion Early adiposity rebound increases the risk of premature puberty in girls.

Objective: To investigate the longitudinal association between peer bullying victimization and internalizing symptoms, and to examine whether parental warmth buffers against this effect,so as to provide a reference for improving the mental health of the special group of children. Methods: Students in grade 4 and grade 5 from three primary schools in Ma’anshan, Anhui Province were selected in Oct. 2017 with informed consent. Height, weight and pubertal development were objectively assessed. Internalizing symptoms and peer bullying victimization were evaluated at baseline and 1-year follow-up by using the MacArthur Health and Behavior Questionnaire-Child. Children were classified into three groups as non-bullying, non-consistent and consistent bullying victimization group. Multiple linear regression model was used to analyze whether the association between peer bullying victimization and internalizing symptoms varied across different parental warmth groups. Results: Compared with non-bullying victimization group, consistent-and non-consistent bullying victimization had higher internalizing symptoms at baseline and 1-year follow-up(P<0.01). Students reported consistent, non-consistent bullying victimization under moderate parental warmth had lower internalizing symptoms at baseline and 1-year follow-up than those reported under low parental warmth group(P<0.01). Multiple liner regression showed that consistent bullying victimization [β=0.66(95%CI=0.33-0.99), 0.37(95%CI=0.15-0.59), 0.58(95%CI=0.31-0.84), P<0.05] and non-consistent bullying victimization[β=0.33(95%CI=0.18-0.47), 0.28(95%CI=0.13-0.41), 0.29(95%CI=0.08-0.51),P<0.05] were associated with higher 1-year follow-up internalizing symptoms in non-consistent, moderate-and low parental warmth group, while such association was not observed in consistent parental warmth group. Abstract The experience of peer bullying victimization increases the risk of internalizing symptoms and this finding suggests that parental warmth help to buffer children from the internalizing symptoms associated with bullying victimization.

Objective: To explore the impact of adverse childhood experiences on pubertal development,and to provide a reference for conducting the targeted intervention in the early stage. Methods: A cluster sampling method was used to randomly select students of grades 3 to 4 from three primary schools in Ma’anshan municipality of Anhui province in October 2017. Self-reported childhood adverse experiences (ACEs), including physical, emotional and sexual abuse, as well as physical and emotional neglect were collected. Testicular volume and breast Tanner stage were assessed. A follow-up survey was conducted one year later to assess ACEs and pubertal development. ACEs of each dimension were divided into non-exposure group, transient exposure group and sustained exposure group according to ACEs exposure at baseline and follow-up. Multivariate linear regression model was used to analyze the relationship between ACEs exposure and pubertal development after 1-year follow-up. Results: Sustained emotional abuse was positively associated with increased breast Tanner stage and testicular volume (breast: β=0.36, 95%CI=0.09-0.63, P<0.01; testicular volume: β=1.07, 95%CI=0.47-1.66, P<0.01); sustained physical abuse was positively associated with decreased testicular volume (β=-0.83, 95%CI=-1.58--0.08, P<0.05); sustained and transient sexual abuse were significant positively associated with decreased breast Tanner stages (sustained: β=-1.43, 95%CI=-2.86--0.02, P<0.05; transient: β=-0.45, 95%CI=-0.73--0.19, P<0.05); sustained emotional neglect was positively associated with increased breast Tanner staging (β=0.33, 95%CI=0.06-0.61, P<0.05) and decreased testicular volume (β=-0.19, 95%CI=-1.38--0.19, P<0.01). Conclusion Sustained emotional abuse was associated with early pubertal development in boys and girls,and the specitic mechanisam differences of different ACES puberty development effects and the gender differences of the same ACES puberty development effects need to be furthur explored.