Objective To determine the normal ranges of N-terminal pro-brain natriuretic peptide(NT-proBNP) in normal children and children with symptoms of heart failure(HF),and to study their clinical implications.Methods Concentrations of serum NT-proBNP were determined in 80 normal children and 70 children with clinical symptoms of HF.Venous blood was taken in each subject,and plasma NT-proBNP was determined by ELISA method.Eighty normal children included 40 boys and 40 girls.Their ages ranged from 1 to 16 years old.Seventy children with HF were divided into two groups.The first group(n=45,21 males,24 females) included children with symptoms of HF caused by dilated cardiomyopathy(DCM).Their ages ranged from 1 to 16 years,and they had a left ventricular ejection fraction(LVEF) of less than 50%.The second group(n=25,11 male,14 female) consisted of children with symptoms of HF due to ventricular septal defect(VSD).Their ages ranged from 1 to 16 years,and they had an LVEF of 51%-78%.The serum NT-pro BNP levels were determined by ELISA method and LVEF was measured by echocardiography and clinical symptom score of heart failure was defined by using Ross Score.Results Serum concentration of NT-proBNP was 223.05 fmol/mL in normal children from 1 to 16 years old.NT-proBNP levels did not show a significant age-related or sex-related differences.In children with HF,the plasma NT-proBNP levels were significantly elevated(mean:1353.3 fmol/mL) compared to normal children(t=8.964 P

Objective:To improve the teaching quality of in-service clinical pharmacist training. Methods:According to the traits of in-service pharmacists and teaching methods, combined with problem-based learning ( PBL), peer-led team learning(PLTL) and lecture-based learning ( LBL) , a standard teaching mode for in-service clinical pharmacists was explored and established. Results:The teaching mode could not only improve the study enthusiasm of students, but also let them master the study methods, and team co-operation consciousness was strengthened. Conclusion:An integrated teaching mode of LBL, PBL and PLTL has a good teaching effect on clinical pharmacist training.

AIM: To develop a method to determine the content of emodin and chrysophanol in Fuyanling Effervescent Tablets(Radix et Rhizoma Rhei, Flos Lonicerae, Radix Sophorae Tonkinensis, etc.). METHODS: HPLC was used to determine the content of emodin and chrysophanol in Fuyanling Effervescent Tablets. The separation was performed on YWG ODS column with methanol (0.1%) phosphoric acid(85∶15) mixture as a mobile phase and the wavelength of UV detector was at 254nm. RESULTS: The resolution and the linearity of this method was good. in the range of emodin was 50.2～401.6ng( r =0.9999); chrysophanol was 49.9～ 399.2 ng( r =0.9994); and with the average recovery of emodin: 99.4%( RSD =2.2%); chrysophanol:100%( RSD =1.1%). CONCLUSION: The method is simple, rapid and satisfactory and suitable for quality control of Fuyanling Effervescent Tablets.

Objective To investigate the effects of glycyrrhizin on gene expression of transforming growth factor(TGF)-?signaling pathway of hepatic stellate cell(HSC)in mice by gene microarray tech- nique.Methods The HSCs were isolated from mice and cultured in vitro.Then the mice were divided into control group,TGF-?_1 group(5 ng/ml) or TGF-?_1(5 ng/ml)combined with glycyrrhizin(100?mol/L) group.The cells were collected after 10 hours to extract RNA.A cDNA microarray(GEArray~(TM) Q) targeting TGF-?/BMP signal transduction was used to screen the genes which showed significant changes in expression of TGF-?pathway of HSC by glycyrrhizin.Results The microarray analysis showed that 16 genes(16.7%),such as Smad2,Smad3,Smad7,CoL3A1,CoL1A2,and PAI-1,were upregulated by TGF-?_1 and then down-regulated by glycyrrhizin.Five genes(5.2%)(including BMP7,IGFbp3 and etc.)downregulated by TGF-?_1,were then up-regulated by glycyrrhizin.Finally,2 genes upregulated by TGF-?_1 were then up-regulated predominantly by glycyrrhizin in HSC(T?R2,betaglycan).Changes in some genes,such as Smad2 Smad3,Smad7,were further confirmed to be coincided with cDNA microarray by semi-quantitative RT-PCR.Conclusions The anti-fibrosis mechanisms of glycyrrhizin may be through to interference of TGF-?signaling pathway,decrease the synthesis and increase the degradation of collagen.

0.05);2)After 12,24,36 months' treatment,BP was decreased significantly in each group (P0.05).Conclusion Both combined spirono- lactone/HCTZ and captopril/HCTZ significantly reduced BP and LVMI or LVMI and the maguitude of reduction was further enhanced after prolonged treatment.

BACKGROUNDCoronary artery lesions (CALs) are known to be the main complication in children with Kawasaki disease (KD). Instead of intravenous immunoglobulin (IVIG), corticosteroid therapy has been accepted to be used for children with KD who are unresponsive to IVIG. This study aimed to evaluate risk factors for CALs in children with KD.

METHODSWe retrospectively reviewed the clinical records of 2331 children with KD from January 2005 to December 2014. To identify the independent risk factors for CALs, multivariable logistic regression models were constructed using significant variables identified from univariate logistic regression analysis.

RESULTSThe incidence of CALs was 36.0% (840 of 2331), including 625 (26.8%) coronary artery dilations and 215 (9.2%) coronary artery aneurysms (CAAs). Multivariable logistic regression analysis identified that male, incomplete KD, longer fever duration, and C-reactive protein (CRP) >100 mg/L were independent risk factors for coronary artery dilatations. On the other hand, male, incomplete KD, longer fever duration, prolonged days of illness at the initial treatment, corticosteroid therapy, sodium ≤133 mmol/L, and albumin <35 g/L were the independent risk factors for CAAs. In addition, corticosteroid therapy, prolonged days of illness at the initial treatment, and albumin <35 g/L were the independent risk factors for giant CAAs.

CONCLUSIONSCALs might be associated with male sex, incomplete KD, longer fever duration, prolonged days of illness at the initial treatment, albumin <35 g/L, sodium ≤133 mmol/L, CRP >100 mg/L, and corticosteroid therapy. Corticosteroid therapy was an independent risk factor for CAAs and giant CAAs. Thus, corticosteroids should be used with caution in the treatment of KD with the risk for CALs.

Adolescent ; Adrenal Cortex Hormones ; adverse effects ; Child, Preschool ; Coronary Aneurysm ; chemically induced ; Female ; Humans ; Infant ; Logistic Models ; Male ; Mucocutaneous Lymph Node Syndrome ; drug therapy ; Retrospective Studies

Cardiac Surgical Procedures ; instrumentation ; methods ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Infant ; Male ; Treatment Outcome

OBJECTIVEOverseas research has shown the value of brain natriuretic peptide (BNP) in the diagnosis and treatment of heart failure in children. However, a reference range of BNP values is lacking, limiting its clinical application. This study was designed to determine a reference range for children aged 1 to 16 years.

METHODSPlasma BNP (BNP32, NT-proBNP) concentrations were measured in 190 healthy children (95 boys and 95 girls) using an enzyme immunoassay. Their age ranged from 1 to 16 years (mean=10.6 +/- 4.2 years).

RESULTSThe mean plasma concentration of BNP32 in 190 children was 51.89 +/- 48.36 pg/mL, with the 10th and the 90th percentile rank of 27.00 pg/mL and 75.00 pg/mL respectively. The mean plasma concentration of BNP32 in girls was 60.33 +/- 62.91 pg/mL, and 44.22 +/- 27.14 pg/mL in boys, but no statistical differences were found. The mean plasma concentration of NT-proBNP in 190 children was 246.04 +/- 67.27 fmol/mL. The girls had slightly higher plasma NT-proBNP levels than the boys, but there were no statistical differences between them. Neither plasma BNP32 concentration nor NT-proBNP concentration was related to age.

CONCLUSIONSThis study first reported a reference range of BNP values for healthy Chinese children aged 1-16 years. Both age and gender are not related to BNP values.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Reference Values ; Sex Factors

Objective To investigate the dynamic changes of transcription profiles of mouse thymus gene expression in different times after 6 Gy γ-irradiation.Methods High-flux cDNA microarray technique was used irradiation,the numbers and types of differentially expressed genes were gradually decreased,for instance,the induced differential expression genes were involved in cell cycle,immunity and stress,apeptosis,signal transduction,transcription regulation,DNA synthesis and recombination,cystoskeleton,ion channel and transportation,metabolism,protein translation and synthesis,development and cell differentiation,etc.correlated cell cycle(3 up-regulating:Cyclin G,Anxal,Fgf1 and 2 down-regulating:Cdc2a,Cdc25b),5 genes correlated immune stress(4 up-regulating:IL-18,Casp1,IL-15,IL-7 and 1 down-regulating:Cd28),7 genes correlated apoptosis(4 up-regulating:Caspl,Anxal,Perp,IL-7 and 3 down-regulating:Pten,Api5 and Fas).Conclusions After 6 Gy irradiation,differentially expressed genes in mouse thymus is not only involved in many targets,levels and pathways,but also displayed an obvious difference in times.This reveals the regular pattern of differential expression genes in the process of injury and reconstitution in moderate dose irradiated mouse thymus.

Objective To observe the effect of γ-ray irradiation on CD4 + CD25 + regulatory T cells (Tregs),and to investigate the mechanism of immune injury induced by irradiation.Methods The thymus and spleen of C57BL/6 mice were taken and weighted 1-28 d after γ-ray irradiation,and the organ coefficients were calculated.The amount of mouse peripheral WBC measured,CD4 + T cells and Tregs in peripheral and splenic were analyzed by flow cytometry.Results Coefficients of mouse thymus and spleen decreased significantly 1 d post irradiation,and reached to the bottom at 7 d.Coefficients did not recover to control level 28 d after radiation.Peripheral WBC continuously decreased and reached the bottom at 7 d,and did not recover to control level up to 28 d postirradiation.Peripheral CD4 + T lymphocyte temporally reduced at 1 d,while it increased at 7 d,and it approached to control level at 28 d after radiation.Splenic CD4 + T cells slightly reduced at 7 d however,they basically maintained as the same level as control 14 d and 28 d after radiation.Peripheral Tregs ascended at 1 d and reached the peak at 7 d,and reduced at 14 d and 28 d postirradiation,although they still were significantly higher than those of control group.At the same time,splenic Tregs increased significantly and achieved peak value at 1 d,and then gradually decreased and reached the minimum at 28 d after irradiation,which were significantly lower than those of control group( t =2.731,P ＜ 0.05).Conclusions Mouse thymus and spleen were injured severely,and the number of immunocytes decreased after 6 Gy whole body γ-ray irradiation.However,Tregs with immunosuppressive action increased significantly postirradiation,revealing that Tregs were closely correlated with immune function depression and immunomodulation imbalance induced by ionizing radiation.